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Ditsch N, Untch M, Fasching PA, Busch S, Ettl J, Haidinger R, Jackisch C, Lüftner D, Müller L, Müller V, Ruckhäberle E, Schumacher-Wulf E, Thomssen C, Harbeck N, Wuerstlein R. ABC7 Consensus: Assessment by a German Group of Experts. Breast Care (Basel) 2024; 19:116-128. [PMID: 38638343 PMCID: PMC11023691 DOI: 10.1159/000535997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 04/20/2024] Open
Abstract
Background The "International Consensus Conference for Advanced Breast Cancer" was initiated more than 10 years ago. The rationale was to standardize treatment of advanced breast cancer (ABC) based on available evidence and to ensure that all ABC patients worldwide receive adequate treatment and access to new therapies. Topics of ABC7 The 7th International Consensus Conference for ABC (ABC7) took place from November 9 to 11, 2023 - as in previous years in Lisbon/Portugal. ABC7 focused not only on metastatic disease but also on locally advanced and inflammatory breast cancer. Special topics were the management of oligometastatic disease, leptomeningeal disease, brain metastases, and pregnant women with ABC. Due to the current situation worldwide, there was a special interest to patients living in conflict zones. As in previous years, patient advocates from around the world were integrated into the ABC conference and had a major input to the consensus. Rationale for the Manuscript A German breast cancer expert panel comments on the voting results of the ABC7 panelists regarding their relevance for routine clinical practice in Germany. As with previous meetings, the ABC7 votes focused on modified or new statements. Regarding the statements not modified for the ABC7 consensus, they are discussed in the published manuscript from 2021 in which the German experts commented on the ABC6 consensus. The German comments are always based on the current recommendations of the "Breast Committee" of the Gynecological Oncology Working Group (Arbeitsgemeinschaft Gynäkologische Onkologie, AGO Mamma).
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Affiliation(s)
- Nina Ditsch
- Department of Gynecology and Obstetrics, Breast Cancer Center, University Hospital Augsburg, Augsburg, Germany
| | - Michael Untch
- Department of Gynecology and Obstetrics, Multidisciplinary Breast Cancer and Gynecologic Oncology Center, HELIOS Klinikum Berlin Buch, Berlin, Germany
| | - Peter A. Fasching
- Women’s Hospital at the University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Steffi Busch
- Onkologische Schwerpunktpraxis, Dr. Busch MVZ GmbH, Mühlhausen, Germany
| | - Johannes Ettl
- Department of Gynecology and Obstetrics, Clinic for Hematology, Oncology and Palliative Care, Klinikverbund Allgäu gGmbH, Klinikum Kempten, Kempten, Germany
| | - Renate Haidinger
- Brustkrebs Deutschland e.V.; Patient Advocate, Board Member ABC Global Alliance, Munich, Germany
| | - Christian Jackisch
- Department of Gynecology and Obstetrics, Sana Klinikum Offenbach, Offenbach, Germany
| | - Diana Lüftner
- Immanuel Hospital Märkische Schweiz, Buckow, Germany, and Immanuel Hospital Rüdersdorf, Medical University of Brandenburg, Rüdersdorf, Germany
| | - Lothar Müller
- Onkologie UnterEms, Studienzentrum UnterEms, Leer, Germany
| | - Volkmar Müller
- Department of Gynecology, University Hospital, Hamburg-Eppendorf, ABC7 Panel Member, Hamburg, Germany
| | - Eugen Ruckhäberle
- Department of Obstetrics and Gynecology of The Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Eva Schumacher-Wulf
- Mamma Mia! Breast cancer magazine, Patient Advocate, Co-chair, ABC7 Panel Member, Köln, Germany
| | | | - Nadia Harbeck
- Breast Center and Comprehensive Cancer Center (CCC) Munich, University of Munich (LMU), Department of Obstetrics and Gynecology, ABC7 Panel Member, Munich, Germany
| | - Rachel Wuerstlein
- Breast Center and Comprehensive Cancer Center (CCC) Munich, University of Munich (LMU), Department of Obstetrics and Gynecology, Munich, Germany
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Pixberg C, Schulze M, Buschhorn L, Suppelna JP, Mock A, Hlevnjak M, Heublein S, Schumacher-Wulf E, Schneeweiss A. Reimbursement in the Context of Precision Oncology Approaches in Metastatic Breast Cancer: Challenges and Experiences. Breast Care (Basel) 2024; 19:10-17. [PMID: 38384493 PMCID: PMC10878710 DOI: 10.1159/000533902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/30/2023] [Indexed: 02/23/2024] Open
Abstract
Background Precision oncology programs using next-generation sequencing to detect predictive biomarkers are extending therapeutic options for patients with metastatic breast cancer (mBC). Regularly, based on the recommendations of the interdisciplinary molecular tumor board (iMTB), an inclusion in a clinical trial is not possible. In this case, the German health insurance system allows for the application of reimbursement for an off-label drug use. Here, we describe the current challenges and our experience with reimbursement of molecular therapies in mBC. Methods A total of 100 applications for reimbursement of off-label therapies recommended by an iMTB were filed for patients with mBC, of which 89 were evaluable for this analysis. The approval rate was correlated with the molecular level of evidence of the respective therapy according to the National Center for Tumor Diseases (NCT) and European Society for Medical Oncology Scale for Clinical Actionability of molecular Targets (ESCAT) classification as well as with pretreatment therapy lines. Findings Overall, 53.9% (48/89) of reimbursement applications were approved. Applications for therapies based on level of evidence m1 (NCT classification), tier I and II (ESCAT classification) had a significantly and clinically relevant increased chance of reimbursement, while a greater number of previous treatment lines had no significantly increased chance of approval, though a trend of approval toward higher treatment lines was detectable. Interpretation Currently, the German jurisdiction seems to aggravate the clinical implementation of clinically urgently needed molecular therapies.
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Affiliation(s)
- Constantin Pixberg
- Molecular Diagnostics Program, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
- Division of Gynecological Oncology, National Center for Tumor Diseases (NCT), University of Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Markus Schulze
- Molecular Diagnostics Program, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lars Buschhorn
- Molecular Diagnostics Program, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
- Division of Gynecological Oncology, National Center for Tumor Diseases (NCT), University of Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jan Philip Suppelna
- Molecular Diagnostics Program, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
- Division of Gynecological Oncology, National Center for Tumor Diseases (NCT), University of Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andreas Mock
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
- Department of Translational Medical Oncology, NCT Heidelberg, DKFZ, Heidelberg, Germany
| | - Mario Hlevnjak
- Molecular Diagnostics Program, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sabine Heublein
- Division of Gynecological Oncology, National Center for Tumor Diseases (NCT), University of Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Obstetrics and Gynecology, Medical School, University of Heidelberg, Heidelberg, Germany
| | | | - Andreas Schneeweiss
- Division of Gynecological Oncology, National Center for Tumor Diseases (NCT), University of Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
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Wuerstlein R, Cardoso MJ, Ribeiro JM, Haidinger R, Müller V, Lambertini M, Schumacher-Wulf E. Interview ABC7: Bridging the Gap. Breast Care (Basel) 2024; 19:77-83. [PMID: 38384486 PMCID: PMC10878703 DOI: 10.1159/000535632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 02/23/2024] Open
Affiliation(s)
- Rachel Wuerstlein
- Breast Center and CCC Munich, LMU University Hospital Munich, Munich, Germany
| | | | - Joana M. Ribeiro
- Gustave Roussy, Département de médecine oncologique, Villejuif, France
| | - Renate Haidinger
- Brustkrebs Deutschland e.V. (German Breast Cancer Association), Hohenbrunn, Germany
| | - Volkmar Müller
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Matteo Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy
- Department of Medical Oncology, U.O. Clinical di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Cardoso F, Rihani J, Harmer V, Harbeck N, Casas A, Rugo HS, Fasching PA, Moore A, de Courcy J, Pathak P, Haftchenary S, Aubel D, Schumacher-Wulf E. Quality of Life and Treatment-Related Side Effects in Patients With HR+/HER2- Advanced Breast Cancer: Findings From a Multicountry Survey. Oncologist 2023; 28:856-865. [PMID: 37523663 PMCID: PMC10546820 DOI: 10.1093/oncolo/oyad207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/22/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Quality of life (QOL) is a critical factor in decision-making for advanced breast cancer (ABC). There is a need to improve how QOL and treatment-related side effects (SEs) that impact it are clinically assessed. We examined healthcare professionals' (HCPs') and patients' perspectives on the importance of QOL discussions and the impact of SEs on QOL in clinical settings. PATIENTS AND METHODS A cross-sectional online survey was conducted (7/2020-5/2021) among oncologists, nurses, and patients with HR+/HER2- ABC in 7 countries. RESULTS The survey was completed by 502 HCPs and 467 patients. Overall, 88% of oncologists and 49% of patients recalled QOL discussions at follow-up. In the first- through fourth-line (1L, 2L, 3L, and 4L) settings, respectively, 48%, 57%, 79%, and 85% of oncologists reported QOL was very important; 73% and 45% of patients receiving 1L and 2L treatment and 40% receiving 3L+ treatment indicated QOL was important. Patients reported that insomnia, anxiety, back pain, fatigue, diarrhea, hot flashes, low sexual interest, and loss of appetite had a moderate/severe impact on QOL. Of patients experiencing certain SEs, ≥64% did not discuss them with HCPs until there was a moderate/severe impact on QOL. In patients receiving a CDK4/6 inhibitor, SEs, including insomnia, diarrhea, back pain, and fatigue, had a moderate/severe impact on QOL. CONCLUSIONS This survey discovered disconnects between HCPs and patients with ABC on the importance of QOL discussions and the impact of SEs on QOL. These data support the use of ABC-specific QOL questionnaires that closely monitor SEs impacting QOL.
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Affiliation(s)
- Fatima Cardoso
- Department of Oncology, Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal
| | - Julie Rihani
- Department of Oncology, Independent Patient Advocate, Amman, Jordan
| | - Victoria Harmer
- Department of Oncology, Imperial College Healthcare NHS Trust, London, UK
| | - Nadia Harbeck
- Breast Center, Department of Obstetrics and Gynecology, LMU University Hospital Munich, Munich, Germany
| | - Ana Casas
- Department of Oncology, University Hospital Virgen del Rocio, Sevilla, Spain
| | - Hope S Rugo
- Department of Oncology, University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Peter A Fasching
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen–European Metropolitan Region of Nuremberg and Department of Gynecology and Obstetrics, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Adam Moore
- Department of Oncology, Adelphi Real World, Cheshire, UK
| | | | - Purnima Pathak
- Department of Oncology, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Sina Haftchenary
- Department of Oncology, Novartis Pharmaceuticals, Montreal, QC, Canada
| | - Dawn Aubel
- Department of Oncology, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Eva Schumacher-Wulf
- Department of Oncology, Mamma Mia! Breast Cancer Magazine, Kronberg, Germany
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Küemmel S, Harper-Wynne C, Park YH, Franke F, De Laurentiis M, Schumacher-Wulf E, Eiger D, Heeson S, Shivhare M, Restuccia E, O’Shaughnessy J. Abstract OT2-03-01: heredERA Breast Cancer: Phase III study of first-line, fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection ± giredestrant (GDC-9545) for estrogen receptor+, HER2+ advanced breast cancer. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-ot2-03-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
BACKGROUND Giredestrant is a highly potent, nonsteroidal, oral selective estrogen receptor antagonist and degrader (SERD) that was found to be well tolerated and active as a monotherapy and in combination therapy in Phase I/II studies in early BC and pretreated locally advanced/metastatic BC (LA/mBC). Dual HER2 blockade with pertuzumab + trastuzumab (PH) + a taxane (induction therapy) followed by maintenance PH is the first-line standard of care for most patients (pts) with HER2+ LA/mBC. Despite HER2–ER blockade synergy, paucity of Phase III data evaluating maintenance PH + endocrine therapy (ET) vs. PH in pts with ER+/HER2+ LA/mBC leads to variable use of ET in this setting. Adding giredestrant to the maintenance phase could improve outcomes. TRIAL DESIGN This is a Phase III, randomized, two-arm, open-label, multicenter study evaluating the efficacy and safety of giredestrant + the fixed-dose combination of PH for subcutaneous injection (PH FDC SC) vs. PH FDC SC after induction therapy with PH FDC SC + a taxane in pts with ER+/HER2+ LA/mBC. In the induction phase, pts will receive 4–6 PH FDC SC cycles (1200 mg P/600 mg H in the first cycle, followed by 600/600 mg every 3 weeks) + a taxane (investigator choice of docetaxel/paclitaxel). Pts deriving clinical benefit may receive two additional cycles per investigator’s discretion. Pts completing ≥4 induction therapy cycles, achieving at least stable disease, and with a left ventricular ejection fraction (LVEF) ≥50% will be randomly assigned 1:1 to maintenance giredestrant 30 mg/day + PH FDC SC every 3 weeks or PH FDC SC only, until disease progression (PD). ET (aromatase inhibitor/tamoxifen) will be allowed in the PH FDC SC-only arm. Study treatment will continue until PD, limiting toxicity, death, or consent withdrawal. ELIGIBILITY Enrolled pts must have ER+/HER2+ LA/mBC, disease-free interval from completion of (neo)adjuvant non-ET ≥6 months, Eastern Cooperative Oncology Group performance status 0/1, LVEF ≥50%, and adequate organ function. Pts with prior SERD treatment or presence of symptomatic central nervous system metastases will be excluded. All men and pre-/perimenopausal women must be eligible for a luteinizing hormone-releasing hormone agonist. AIMS The primary endpoint is investigator-assessed, maintenance progression-free survival. Secondary endpoints include overall survival (OS), objective response rate, duration of response, clinical benefit rate, pt-reported outcomes, and safety. STATISTICAL METHODS The primary endpoint analysis will use a stratified log-rank test at an overall 0.05 significance level (two-sided). An interim OS analysis is planned, and an independent data monitoring committee will be in place. ACCRUAL The study is open for enrollment. Approximately 812 pts will be enrolled in the induction phase, to allow for approximately 730 pts to be randomized in the maintenance phase. CONTACT INFORMATION For more information or to refer a patient, email global.rochegenentechtrials@roche.com or call 1-888-662-6728 (USA only). Clinicaltrials.gov number: NCT05296798.
Citation Format: Sherko Küemmel, Catherine Harper-Wynne, Yeon H. Park, Fábio Franke, Michelino De Laurentiis, Eva Schumacher-Wulf, Daniel Eiger, Sarah Heeson, Mahesh Shivhare, Eleonora Restuccia, Joyce O’Shaughnessy. heredERA Breast Cancer: Phase III study of first-line, fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection ± giredestrant (GDC-9545) for estrogen receptor+, HER2+ advanced breast cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr OT2-03-01.
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Affiliation(s)
| | | | - Yeon H. Park
- 3Samsung Medical Center, Seoul, Republic of Korea
| | - Fábio Franke
- 4Centro de Pesquisa Clinica Em Oncologia, Ijuí – RS, Brazil
| | | | | | | | | | | | | | - Joyce O’Shaughnessy
- 11Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX, USA
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Messinger D, Bleß HH, Haidinger R, Schumacher-Wulf E, Lux MP. Use of prognostic gene expression profiling tests in primary breast cancer treatment: a German real-world patient survey. Future Oncol 2022; 18:4371-4383. [PMID: 36656171 DOI: 10.2217/fon-2022-0354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Aims: In primary breast cancer, gene expression profiling tests can support adjuvant chemotherapy treatment decisions. Real-world test use in Germany was investigated in an online survey of female breast cancer patients (n = 475). Materials & methods: Relationships between three groups were examined for clinical and statistical relevance: no test indication (n = 353), test indication and tested (n = 65), and test indication but not tested (n = 57). Results: A total of 47% of participants with a test indication were not tested. Test rates increased by 23% from 2012-2018 (49%) to 2019-2021 (60%). A total of 65% of patients without testing received chemotherapy, whereas only 38% of tested patients received chemotherapy. Conclusion: The use of gene expression profiling tests correlates with a real-world chemotherapy reduction. Gene expression profiling testing may improve patient confidence in the decision for or against chemotherapy.
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Affiliation(s)
| | | | | | | | - Michael Patrick Lux
- Klinik für Gynäkologie und Geburtshilfe, Frauen- und Kinderklinik St. Louise, Paderborn, 33098, Germany
- Klinik für Gynäkologie und Geburtshilfe, St. Josefs-Krankenhaus, Salzkotten, 33154, Germany
- Klinik für Gynäkologie und Geburtshilfe, St. Vincenz Krankenhaus GmbH, Paderborn, 33098, Germany
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Untch M, Fasching PA, Haidinger R, Harbeck N, Jackisch C, Lüftner D, Müller V, Schumacher-Wulf E, Würstlein R, Thomssen C. Advanced Breast Cancer: AGO Recommendations 2022 - Focus on ABC6 Consensus. Geburtshilfe Frauenheilkd 2022; 82:1044-1054. [PMID: 36186150 PMCID: PMC9525147 DOI: 10.1055/a-1904-6100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 07/18/2022] [Indexed: 12/05/2022] Open
Abstract
Over the past few years, there have been many developments in the treatment of advanced breast cancer; these have been incorporated into national and international treatment guidelines, resulting in an improved prognosis for these patients. The 6th International Consensus Conference for Advanced Breast Cancer (ABC6) was held in November 2021. The aim is to standardize the treatment of advanced breast cancer based on a high level of evidence, and to make new treatment options accessible to all patients. In this article we discuss the ABC6 consensus in the context of German treatment guidelines, and compare it with clinical practice in Germany. The authors refer to the current recommendations of the Breast Cancer Working Group for Gynecological Oncology (AGO Mamma) published in March 2022. The AGO Breast Cancer Guidelines are updated annually. Since discrepancies between national and international guidelines can occur due to country-specific regulations, this is a useful comparison to make. The German authors refer to the voting results of the ABC6 panelists from 6 November 2021.
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Affiliation(s)
- Michael Untch
- Klinik für Gynäkologie und Geburtshilfe, Multidisziplinäres Brustzentrum und Zentrum für gynäkologische Onkologie, HELIOS Klinikum Berlin Buch, Berlin, Germany,Correspondence/Korrespondenzadresse Prof. Dr. med. Michael Untch Brustzentrum und Zentrum für gynäkologische OnkologieHELIOS Klinikum Berlin
BuchSchwanebecker Chaussee 5013125
BerlinGermany
| | - Peter A. Fasching
- Universitätsfrauenklinik Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Renate Haidinger
- Brustkrebs Deutschland e. V., Hohenbrunn, Germany; Patientenvertreterin, ABC6-Ko-Vorsitz, ABC-Panelistin
| | - Nadia Harbeck
- Brustzentrum, Klinik und Poliklinik für Frauenheilkunde und Comprehensive Cancer Center (CCC) München, LMU Klinikum, München, Germany; ABC-Panelistin
| | - Christian Jackisch
- Klinik für Gynäkologie und Geburtshilfe, Sana Klinikum Offenbach GmbH, Offenbach, Germany
| | - Diana Lüftner
- Immanuel Klinik Märkische Schweiz, Medizinische Hochschule Brandenburg Theodor-Fontane, Buckow, Germany
| | - Volkmar Müller
- Universitätsklinik für Gynäkologie, Hamburg-Eppendorf, Hamburg, Germany
| | | | - Rachel Würstlein
- Brustzentrum, Klinik und Poliklinik für Frauenheilkunde und Comprehensive Cancer Center (CCC) München, LMU Klinikum, München, Germany
| | - Christoph Thomssen
- Universitätsfrauenklinik, Martin-Luther-Universität, Halle an der Saale, Germany; ABC-Panelist
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Swain SM, Nishino M, Lancaster LH, Li BT, Nicholson AG, Bartholmai BJ, Naidoo J, Schumacher-Wulf E, Shitara K, Tsurutani J, Conte P, Kato T, Andre F, Powell CA. Multidisciplinary clinical guidance on trastuzumab deruxtecan (T-DXd)-related interstitial lung disease/pneumonitis-Focus on proactive monitoring, diagnosis, and management. Cancer Treat Rev 2022; 106:102378. [PMID: 35430509 DOI: 10.1016/j.ctrv.2022.102378] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 01/19/2023]
Abstract
Trastuzumab deruxtecan (T-DXd; DS-8201) is an antibody-drug conjugate targeting human epidermal growth factor receptor 2. Interstitial lung disease (ILD)/pneumonitis is an adverse event associated with T-DXd; in most cases, it is low grade (grade ≤ 2) and can be treated effectively but may develop to be fatal in some instances. It is important to increase patient and provider understanding of T-DXd-related ILD/pneumonitis to improve patient outcomes. Drug-related ILD/pneumonitis is a diagnosis of exclusion; other possible causes of lung injury/imaging findings must be ruled out for an accurate diagnosis. Symptoms can be nonspecific, and identifying early symptoms is challenging; therefore, diagnosis is often delayed. We reviewed characteristics of patients who developed T-DXd-related ILD/pneumonitis and its patterns, produced multidisciplinary guidelines on diagnosis and management, and described areas for future investigation. Ongoing studies are collecting data on T-DXd-related ILD/pneumonitis to further our understanding of its clinical patterns and mechanisms. SEARCH STRATEGY AND SELECTION CRITERIA: References were identified based on the guidelines used by the authors in treating interstitial lung disease and pneumonitis. Searches of the authors' own files were also completed. A search of PubMed with the search terms (trastuzumab deruxtecan) AND (interstitial lung disease) AND (guidelines) was conducted on November 1, 2021, with no restrictions based on publication date, and the two articles yielded by the search were included.
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Affiliation(s)
- Sandra M Swain
- Georgetown Lombardi Comprehensive Cancer Center and MedStar Health, 4000 Reservoir Road NW, 120 Building D, Washington DC 20057, United States.
| | - Mizuki Nishino
- Brigham and Women's Hospital and Dana Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, United States
| | - Lisa H Lancaster
- Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37232, United States
| | - Bob T Li
- Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States
| | - Andrew G Nicholson
- Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, and National Heart and Lung Institute, Imperial College, London SW3 6NP, United Kingdom
| | | | - Jarushka Naidoo
- Johns Hopkins University, 1650 Orleans Street, Baltimore, MD 21231, United States; Beaumont Hospital and RCSI University of Health Sciences, 123, 2 St Stephen's Green, Dublin, D02 YN77, Ireland
| | | | - Kohei Shitara
- National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba 277-8577, Japan
| | - Junji Tsurutani
- Advanced Cancer Translational Research Institute, Showa University, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8555, Japan
| | - Pierfranco Conte
- Istituto Oncologico Veneto, I.R.C.C.S and University of Padova, Via Gattamelata, 64, 35128, Padova PD, Italy
| | - Terufumi Kato
- Kanagawa Cancer Center, Nakao 2-3-2, Asahi-ku, Yokohama, 241-8515, Japan
| | - Fabrice Andre
- Gustave Roussy Institute, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - Charles A Powell
- Pulmonary Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, 10 East 102nd Street, New York, NY 10029, United States
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Lüftner D, Fasching PA, Haidinger R, Harbeck N, Jackisch C, Müller V, Schumacher-Wulf E, Thomssen C, Untch M, Würstlein R. ABC6 Consensus: Assessment by a Group of German Experts. Breast Care (Basel) 2022; 17:90-100. [PMID: 35355695 PMCID: PMC8914214 DOI: 10.1159/000522068] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 01/17/2022] [Indexed: 02/03/2023] Open
Abstract
Background The first International Consensus Conference for Advanced Breast Cancer (ABC1) took place 10 years ago in November 2011. The rationale was - and still is - to standardize treatment of advanced breast cancer (ABC) based on the available evidence and to ensure that worldwide all breast cancer patients receive adequate treatment and access to new therapies. Rationale for the Manuscript The 6th International Consensus Conference for ABC (ABC6) took place from November 4 to 6, 2021 and was the first in a purely online format, due to the COVID-19 pandemic. In the present manuscript, a working group of German breast cancer experts comments on the voting results of the ABC6 panelists regarding their applicability for routine clinical practice in Germany. Method The ABC6 votes mainly include modified or new statements. With regard to all statements not modified for the ABC6 consensus, the German experts refer to the published paper of the ABC5 consensus. The German experts base their comments on the current recommendations of the Breast Committee of the Gynecological Oncology Working Group (Arbeitsgemeinschaft Gynäkologische Onkologie, AGO Mamma). Topics ABC6 focused on new treatment options and their implications for clinical practice. Optimal therapy sequencing for example was one of the issues. To solve the challenge of a more individualized treatment, precision medicine is fundamental. Oligometastatic disease, brain metastases and adequate supportive and palliative care were also addressed. Of special interest was the treatment of inoperable locally advanced breast cancer, which was discussed as a separate topic. As in previous years, patient advocates from around the world were an integral part of the ABC6 conference and had a major input into the consensus.
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Affiliation(s)
- Diana Lüftner
- Medical Department of Hematology, Oncology, and Tumor Immunology, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany,*Diana Lüftner,
| | - Peter A. Fasching
- Women's Hospital at the University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Renate Haidinger
- Brustkrebs Deutschland [German Breast Cancer Association] e.V., Hohenbrunn, Germany
| | - Nadia Harbeck
- Breast Center, Department of Obstetrics and Gynecology and Comprehensive Cancer Center (CCC) Munich, LMU University Hospital, Munich, Germany
| | - Christian Jackisch
- Department of Gynecology and Obstetrics, Sana Hospital Offenbach, Offenbach, Germany
| | - Volkmar Müller
- Department of Gynecology, University Hospital, Hamburg-Eppendorf, Germany
| | | | - Christoph Thomssen
- Department of Gynecology, Martin Luther University Halle-Wittenberg, Halle an der Saale, Germany
| | - Michael Untch
- Clinic of Gynecology and Obstetrics, Multidisciplinary Breast Cancer Center, Department of Gynecologic Oncology, HELIOS Klinikum Berlin Buch, Berlin, Germany
| | - Rachel Würstlein
- Breast Center, Department of Obstetrics and Gynecology and Comprehensive Cancer Center (CCC) Munich, LMU University Hospital, Munich, Germany
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Cardoso F, Cella D, Velikova G, Harmer V, Schumacher-Wulf E, Rihani J, Casas A, Harbeck N. Quality-of-life methodology in hormone receptor-positive advanced breast cancer: Current tools and perspectives for the future. Cancer Treat Rev 2021; 102:102321. [PMID: 34852292 DOI: 10.1016/j.ctrv.2021.102321] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/10/2021] [Accepted: 11/15/2021] [Indexed: 12/20/2022]
Abstract
Health-related quality of life (HRQOL) is increasingly recognized as important when evaluating cancer treatments. The use, reporting, and analysis of patient-reported outcome measures (PROMs), however, are not standardized in clinical trials and are often poorly implemented in clinical practice. We report the results of a systematic literature review (PubMed search: January 1, 2000 to August 15, 2020) of PROM use, reporting, and analysis in phase 3 clinical trials of hormone receptor-positive (HR+) advanced breast cancer (ABC). Further inspection of cyclin-dependent kinase 4/6 (CDK4/6) inhibitor publications was performed to examine PROMs in the HR+/human epidermal growth factor receptor 2-negative setting. A total of 88 results were identified in the initial search; 32 were included in the final analysis. Among included studies, most (66%) had been published in the last 5 years (2015 to 2020). CDK4/6 inhibitors (38%) were the most common agents reported. No clear standard for PROM use, reporting, or analysis was found. The most common PROMs were European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30; 59%) and the Functional Assessment of Cancer Therapy-Breast (FACT-B; 34%). Important differences, among studies that reported them, ranged from 5 to 10 points for the EORTC QLQ-C30 and 8 points for the FACT-B total score. This review showed that a lack of clear consistency remains for PROM use, reporting, and analysis in phase 3 clinical trials of HR+ ABC. However, HRQOL is of high interest in the literature, including for CDK4/6 inhibitors.
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Affiliation(s)
- Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal.
| | - David Cella
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Galina Velikova
- Leeds Institute of Medical Research at St. James's University of Leeds and Leeds Teaching Hospitals, Leeds, UK
| | | | | | | | - Ana Casas
- University Hospital Virgen del Rocio (HUVR), Sevilla, Spain
| | - Nadia Harbeck
- Breast Center, Department of Obstetrics and Gynecology, LMU University Hospital Munich, Germany
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11
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Untch M, Würstlein R, Lüftner D, Haidinger R, Fasching PA, Augustin D, Briest S, Ettl J, Förster F, Kurbacher CM, Lück HJ, Marschner N, Müller L, Müller V, Radke I, Ruckhäberle E, Scheffen I, Schumacher-Wulf E, Schwoerer M, Steinfeld-Birg D, Ziegler-Löhr K, Thomssen C, Harbeck N. ABC5 International Consensus Conference on Advanced Breast Cancer, Lisbon, 16 November 2019: Commentary by the German panel of experts on the ABC5 voting results. Geburtshilfe Frauenheilkd 2020; 80:588-600. [PMID: 32565549 PMCID: PMC7299684 DOI: 10.1055/a-1139-9380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/16/2020] [Indexed: 12/11/2022] Open
Abstract
The Advanced Breast Cancer Fifth International Consensus Conference (ABC5) which focuses on the diagnosis and treatment of advanced breast cancer was held in Lisbon on November 14 - 16, 2019. The aim of the conference is to standardize the treatment of advanced breast cancer worldwide using evidence-based data and to ensure that patients with advanced breast disease anywhere in the world are treated appropriately and have access to the latest therapies. This year, the emphasis was on new developments and study results from patients with advanced breast cancer as well as precision medicine. The collaboration with patient advocates from all over the globe is also an important goal of the ABC Conference, which is why the international ABC panel also included a number of patient advocates. We present a commentary on the voting results of the ABC5 panelists in Lisbon by a working group of German breast cancer specialists together with the implications for routine clinical care in Germany. The commentary is based on the recommendations of the Breast Commission of the German Gynecological Oncology Working Group (AGO). This commentary is useful, it includes country-specific features for the ABC consensus.
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Affiliation(s)
- Michael Untch
- Klinik für Gynäkologie und Geburtshilfe, Brustzentrum und Gynäkologisch Onkologisches Zentrum, HELIOS Klinikum Berlin Buch, Berlin, Germany
| | - Rachel Würstlein
- Brustzentrum und Comprehensive Cancer Center (CCC) München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universität München (LMU), München, Germany
| | - Diana Lüftner
- Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und Tumorimmunologie, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
| | | | - Peter A. Fasching
- Universitätsfrauenklinik Erlangen, Comprehensive Cancer Center (CCC) Erlangen-EMN, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Doris Augustin
- Mammazentrum Ostbayern, DONAUISAR Klinikum Deggendorf, Deggendorf, Germany
| | - Susanne Briest
- Klinik und Poliklinik für Frauenheilkunde, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Johannes Ettl
- Frauenklinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum rechts der Isar, München, Germany
| | - Frank Förster
- Praxis für Gynäkologie und Geburtshilfe, Gynäkologische Onkologie und Palliativmedizin, Poliklinik gGmbH, Chemnitz, Germany
| | - Christian M. Kurbacher
- Gynäkologie I (Gynäkologische Onkologie), Gynäkologisches Zentrum, Bonn-Friedensplatz, Bonn, Germany
| | | | - Norbert Marschner
- Gemeinschaftspraxis für interdisziplinäre Onkologie und Hämatologie, Freiburg, Germany
| | - Lothar Müller
- Onkologische Schwerpunktpraxis Leer-Emden-Papenburg, Leer, Emden, Papenburg, Germany
| | - Volkmar Müller
- Universitätsfrauenklinik Hamburg-Eppendorf, Hamburg, Germany
| | - Isabel Radke
- Brustzentrum, Universitätsklinikum Münster, Münster, Germany
| | | | - Iris Scheffen
- Brustzentrum am St. Elisabeth-Krankenhaus GmbH, Köln, Germany
| | | | - Moritz Schwoerer
- Frauenklinik, Klinikum Fürstenfeldbruck, Fürstenfeldbruck, Germany
| | | | | | - Christoph Thomssen
- Universitätsklinik und Poliklinik für Gynäkologie, Martin-Luther-Universität, Halle an der Saale; ABC panel member, ABC scientific committee member, Germany
| | - Nadia Harbeck
- Brustzentrum und Comprehensive Cancer Center (CCC) München, Universität München (LMU), München; ABC panel member, Germany
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12
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Thomssen C, Lüftner D, Untch M, Haidinger R, Würstlein R, Harbeck N, Augustin D, Briest S, Ettl J, Fasching PA, Förster F, Kurbacher CM, Lück HJ, Marschner N, Müller L, Müller V, Perlova-Griff L, Radke I, Ruckhäberle E, Scheffen I, Schumacher-Wulf E, Schwoerer M, Steinfeld-Birg D, Ziegler-Löhr K. International Consensus Conference for Advanced Breast Cancer, Lisbon 2019: ABC5 Consensus - Assessment by a German Group of Experts. Breast Care (Basel) 2020; 15:82-95. [PMID: 32231503 DOI: 10.1159/000505957] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 01/09/2020] [Indexed: 12/12/2022] Open
Abstract
The 5th International Consensus Conference for Advanced Breast Cancer (ABC5) took place on November 14-16, 2019, in Lisbon, Portugal. Its aim is to standardize the treatment of advanced breast cancer based on the available evidence and to ensure that all breast cancer patients worldwide receive adequate treatment and access to new therapies. This year, the conference focused on developments and study results in the treatment of patients with hormone receptor-positive/HER2-negative breast cancer as well as precision medicine. As in previous years, patient advocates from around the world were integrated into the ABC conference and had seats on the ABC consensus panel. In the present paper, a working group of German breast cancer experts comments on the results of the on-site ABC5 consensus votes by ABC panelists regarding their applicability for routine treatment in Germany. These comments take the recommendations of the Breast Committee of the Gynecological Oncology Working Group (Arbeitsgemeinschaft Gynäkologische Onkologie; AGO) into account. The report and assessment presented here pertain to the preliminary results of the ABC5 consensus. The final version of the statements will be published in Annals of Oncology and The Breast.
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Affiliation(s)
- Christoph Thomssen
- Klinik und Poliklinik für Gynäkologie, Martin-Luther-Universität Halle-Wittenberg, Halle an der Saale, Germany
| | - Diana Lüftner
- Medical Department of Hematology, Oncology, and Tumor Immunology, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Michael Untch
- Clinic of Gynecology and Obstetrics, Multidisciplinary Breast Cancer Center, Department of Gynecologic Oncology, HELIOS Klinikum Berlin Buch, Berlin, Germany
| | - Renate Haidinger
- Brustkrebs Deutschland (German Breast Cancer Association) e.V., Hohenbrunn, Germany
| | - Rachel Würstlein
- Breast Center and Comprehensive Cancer Center (CCC) Munich, Department of Obstetrics and Gynecology, University of Munich (LMU), Munich, Germany
| | - Nadia Harbeck
- Breast Center and Comprehensive Cancer Center (CCC) Munich, Department of Obstetrics and Gynecology, University of Munich (LMU), Munich, Germany
| | - Doris Augustin
- Breast Center of Eastern Bavaria, DONAUISAR Hospital of Deggendorf, Deggendorf, Germany
| | - Susanne Briest
- Department of Gynecology, University Hospital Leipzig, Leipzig, Germany
| | - Johannes Ettl
- Department of Gynecology and Obstetrics, University Hospital Rechts der Isar, Munich, Germany
| | - Peter A Fasching
- Women's Hospital at the University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen-Nuremberg, Germany
| | - Frank Förster
- Practice for Gynecology and Obstetrics, Gynecological Oncology and Palliative Care, Poliklinik gGmbH, Chemnitz, Germany
| | - Christian M Kurbacher
- Practice - Gynecology I (Gynecologic Oncology), Gynecologic Center Bonn-Friedensplatz, Bonn, Germany
| | | | - Norbert Marschner
- Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany
| | - Lothar Müller
- Oncology Specialist Practice of Leer-Emden-Papenburg, Leer-Emden-Papenburg, Germany
| | - Volkmar Müller
- Department of Gynecology, University Hospital, Hamburg-Eppendorf, Germany
| | - Lidia Perlova-Griff
- Gynecological Oncology of Wilmersdorf, Treatment Center II of the St. Gertrude Hospital, Berlin, Germany
| | - Isabel Radke
- Breast Center, University Hospital of Münster, Münster, Germany
| | - Eugen Ruckhäberle
- Department of Obstetrics and Gynecology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Iris Scheffen
- Breast Center at St. Elisabeth Hospital, Cologne, Germany
| | | | - Moritz Schwoerer
- Department of Gynecology, Hospital Fürstenfeldbruck, Fürstenfeldbruck, Germany
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13
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Thomssen C, Hasenburg A, Oskay-Özcelik G, Schumacher-Wulf E. GYNECOLOGICAL AND SEXUAL SYMPTOMS: THE SILENT SUFFERING. Breast 2019. [DOI: 10.1016/s0960-9776(19)30626-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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14
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Lüftner D, Bauerfeind I, Braun M, Brucker SY, Fasching PA, Felberbaum R, Hagemann F, Haidinger R, Harbeck N, Hönig A, Huober J, Jackisch C, Kolberg HC, Kolberg-Liedtke C, Kühn T, Maass N, Reimer T, Schneeweiss A, Schumacher-Wulf E, Schütz F, Thomssen C, Untch M, Wuerstlein R, Thill M. Treatment of Early Breast Cancer Patients: Evidence, Controversies, Consensus: Focusing on Systemic Therapy - German Experts' Opinions for the 16th International St. Gallen Consensus Conference (Vienna 2019). Breast Care (Basel) 2019; 14:315-324. [PMID: 31798392 PMCID: PMC6883436 DOI: 10.1159/000502603] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 08/09/2019] [Indexed: 02/04/2023] Open
Abstract
A German working group of leading breast cancer experts have discussed the votes at the International St. Gallen Consensus Conference in Vienna for the treatment of primary breast cancer with regard to the German AGO (Ar-beitsgemeinschaft Gynäkologische Onkologie) recommendations for clinical practice in Germany. Three of the German breast cancer experts were also members of this year's St. Gallen panel. Comparing the St. Gallen recommendations with the annually updated treatment recommendations of the Gynecological Oncology Working Group (AGO Mamma 2019) and the German S3 Guideline is useful, because the recommendations of the St. Gallen panel are based on expert opinions of different countries and disciplines. The focus of this article is on systemic therapy. The motto of this year's 16th St. Gallen Consensus Conference was "Estimating the magnitude of clinical benefit." The rationale behind this motto is that, for every treatment decision, a benefit-risk assessment must be taken into consideration for each patient.
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Affiliation(s)
- Diana Lüftner
- Department of Hematology, Oncology and Tumour Immunology, Charité – Campus Benjamin Franklin, Berlin, Germany
| | - Ingo Bauerfeind
- Interdisciplinary Breast Cancer Center, Women's Hospital, Landshut Hospitals, Landshut, Germany
| | - Michael Braun
- Interdisciplinary Breast Center, Women's Hospital, Red Cross Hospital Munich, Munich, Germany
| | | | - Peter A. Fasching
- Women's Hospital at the University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Ricardo Felberbaum
- Hospital Association Kempten-Oberallgäu, Kempten Hospitals, Kempten, Germany
| | - Friederike Hagemann
- Breast Center, Women's Hospital at the Ludwig Maximillian University Munich (LMU), Munich, Germany
| | | | - Nadia Harbeck
- Breast Center, Women's Hospital at the Ludwig Maximillian University Munich (LMU), Munich, Germany
| | - Arnd Hönig
- Breast Center, Women's Hospital, Catholic Hospital Mainz, Mainz, Germany
| | - Jens Huober
- Breast Center, University Women's Hospital Ulm, Ulm, Germany
| | - Christian Jackisch
- Department of Gynecology and Obstetrics, Sana Clinic Offenbach, Offenbach, Germany
| | - Hans-Christian Kolberg
- Breast Center, Department of Gynecology and Obstetrics, Marienhospital Bottrop gGmbH, Bottrop, Germany
| | | | - Thorsten Kühn
- Department of Gynecology and Obstetrics, Esslingen Hospitals, Esslingen, Germany
| | - Nicolai Maass
- Breast Center, Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Toralf Reimer
- Breast Center, University Women's Hospital and Outpatient Clinic, Clinics Südstadt Rostock, Rostock, Germany
| | - Andreas Schneeweiss
- National Centrum for Tumor Disease (NCT), University Hospital (UKHD), and German Cancer Research Site (DKFZ), Heidelberg, Germany
| | | | - Florian Schütz
- Senology Department, Breast Center, University Hospital in Heidelberg, Heidelberg, Germany
| | - Christoph Thomssen
- University Hospital and Outpatient Department of Gynecology, Halle (Saale), Germany
| | - Michael Untch
- Department of Gynecology and Obstetrics, Interdisciplinary Breast Center, HELIOS Hospitals Berlin Buch, Berlin, Germany
| | - Rachel Wuerstlein
- Breast Center, Women's Hospital at the Ludwig Maximillian University Munich (LMU), Munich, Germany
| | - Marc Thill
- Department of Gynecology and Obstetrics, Interdisciplinary Breast Center, Agaplesion Markus Hospital, Frankfurt/M., Germany
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15
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Untch M, Thomssen C, Bauerfeind I, Braun M, Brucker SY, Felberbaum R, Hagemann F, Haidinger R, Hönig A, Huober J, Jackisch C, Kolberg HC, Kolberg-Liedtke C, Kühn T, Lüftner D, Maass N, Reimer T, Schneeweiss A, Schumacher-Wulf E, Schütz F, Thill M, Wuerstlein R, Fasching PA, Harbeck N. Primary Therapy of Early Breast Cancer: Evidence, Controversies, Consensus: Spectrum of Opinion of German Specialists on the 16th St. Gallen International Breast Cancer Conference (Vienna 2019). Geburtshilfe Frauenheilkd 2019; 79:591-604. [PMID: 31217628 PMCID: PMC6570611 DOI: 10.1055/a-0897-6457] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 04/20/2019] [Accepted: 04/21/2019] [Indexed: 12/22/2022] Open
Abstract
The results of the international St. Gallen Consensus Conference for the treatment of patients with primary breast cancer were discussed this year by a working group of leading breast cancer experts in view of the therapy recommendations for everyday clinical practice in Germany. Three of the breast cancer experts are also members of this year's St. Gallen panel. The comparison of the St. Gallen recommendations with the annually updated treatment recommendations of the AGO 2019 as well as the S3 guideline is useful, since the recommendations of the St. Gallen panel represent the opinions of experts from various countries and disciplines. The recommendations of the S3 guideline and AGO are based on evidence-based research of the literature. This year's 16th St. Gallen conference featured the motto "Magnitude of clinical benefit". In addition to the evidence-based data, each therapeutic decision must also undergo a benefit/risk assessment of the patient's individual situation and be discussed with the patient.
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Affiliation(s)
- Michael Untch
- Klinik für Gynäkologie und Geburtshilfe, interdisziplinäres Brustzentrum, HELIOS Klinikum Berlin Buch, Berlin, Germany
| | - Christoph Thomssen
- Klinik und Poliklinik für Gynäkologie, Martin-Luther-Universität, Halle-Wittenberg, Halle/Saale, Germany
| | - Ingo Bauerfeind
- Interdisziplinäres Brustkrebszentrum, Frauenklinik, Klinikum Landshut, Landshut, Germany
| | - Michael Braun
- Interdisziplinäres Brustzentrum, Frauenklinik, Rotkreuzklinikum München, München, Germany
| | | | - Ricardo Felberbaum
- Interdisziplinäres Brustzentrum Kempten – Allgäu (IBZK-A), Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Kempten-Oberallgäu, Kempten, Germany
| | | | | | - Arnd Hönig
- Brustzentrum, Frauenklinik, Katholisches Klinikum Mainz, Mainz, Germany
| | - Jens Huober
- Universitätsfrauenklinik Ulm, Brustzentrum, Ulm, Germany
| | - Christian Jackisch
- Klinik für Gynäkologie und Geburtshilfe, Sana-Klinikum Offenbach, Offenbach, Germany
| | - Hans-Christian Kolberg
- Brustzentrum, Klinik für Gynäkologie und Geburtshilfe, Marienhospital Bottrop gGmbH, Bottrop, Germany
| | | | - Thorsten Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen, Esslingen, Germany
| | - Diana Lüftner
- Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und Tumorimmunologie, Charité Campus Benjamin Franklin, Berlin, Germany
| | - Nicolai Maass
- Brustzentrum, Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Toralf Reimer
- Brustzentrum, Universitätsfrauenklinik und Poliklinik, Klinikum Südstadt Rostock, Rostock, Germany
| | - Andreas Schneeweiss
- Sektionsleiter Gynäkologische Onkologie des Universitätsklinikum (UKHD), Fellow des Deutschen Krebsforschungszentrum (DKFZ), Nationales Centrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | - Florian Schütz
- Brustzentrum, Sektion Senologie, UniversitätsKlinikum Heidelberg, Heidelberg, Germany
| | - Marc Thill
- Klinik für Gynäkologie und Gynäkologische Onkologie, Agaplesion Markus Krankenhaus, Frankfurt/Main, Germany
| | - Rachel Wuerstlein
- Brustzentrum, Frauenklinik der Universität München (LMU), München, Germany
| | - Peter A. Fasching
- Frauenklinik des Universitätsklinikums Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Nadia Harbeck
- Brustzentrum, Frauenklinik der Universität München (LMU), München, Germany
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