Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013

By A. Goldhirsch, E. Winer, A. Coates, R. Gelber, M. Piccart-Gebhart, B. Thürlimann, H. Senn, K. Albain, F. André, J. Bergh and 42 more. Annals of Oncology, 2013

3,678 citations recorded by the source corpus.

The 13th St Gallen International Breast Cancer Conference (2013) Expert Panel reviewed and endorsed substantial new evidence on aspects of the local and regional therapies for early breast cancer, supporting less extensive surgery to the axilla and shorter durations of radiation therapy. It refined its earlier approach to the classification and management of luminal disease in the absence of amplification or overexpression of the Human Epidermal growth factor Receptor 2 (HER2) oncogene, while retaining essentially unchanged recommendations for the systemic adjuvant therapy of HER2-positive and ‘triple-negative’ disease. The Panel again accepted that conventional clinico-pathological factors provided a surrogate subtype classification, while noting that in those areas of the world where multi-gene molecular assays are readily available many clinicians prefer to base chemotherapy decisions for patients with luminal disease on these genomic results rather than the surrogate subtype definitions. Several multi-gene molecular assays were recognized as providing accurate and reproducible prognostic information, and in some cases prediction of response to chemotherapy. Cost and availability preclude their application in many environments at the present time. Broad treatment recommendations are presented. Such recommendations do not imply that each Panel member agrees: indeed, among more than 100 questions, only one (trastuzumab duration) commanded 100% agreement. The various recommendations in fact carried differing degrees of support, as reflected in the nuanced wording of the text below and in the votes recorded in supplementary Appendix S1, available at Annals of Oncology online. Detailed decisions on treatment will as always involve clinical consideration of disease extent, host factors, patient preferences and social and economic constraints.

Subfields: Cancer Research, Oncology, Pulmonary and Respiratory Medicine

View Paper: https://www.semanticscholar.org/paper/c3a21bd8f227704e54ffc0407ee5f1418e4bda24

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Citations in the corpus

Tumor infiltrating lymphocytes are prognostic in triple negative breast cancer and predictive for trastuzumab benefit in early breast cancer: results from the FinHER trial. (2014, background): “While our finding may not change current chemotherapy options for TNBC patients, this is still a clinically relevant finding as TILs could be useful as stratification or adjustment factor in future clinical studies, as well as providing the rationale for evaluating immunotherapeutic approaches [25].”
Use of Biomarkers to Guide Decisions on Adjuvant Systemic Therapy for Women With Early-Stage Invasive Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline. (2016, background): “analysis lacks reproducibility across laboratories and, therefore, cannot be consistently interpreted when performed in a broad range of laboratories.(71-75) IHC for Ki-67 is not recommended for broad clinical use to determine whether a patient should receive chemotherapy.”
Survival analysis across the entire transcriptome identifies biomarkers with the highest prognostic power in breast cancer (2021, methodology): “Molecular subtypes were determined using the StGallen criteria [15].”
miRpower: a web-tool to validate survival-associated miRNAs utilizing expression data from 2178 breast cancer patients (2016, background): “Distinct histopathological features are routinely used as prognostic and predictive markers, ultimately driving clinical treatment decisions [2].”
Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. (2015, methodology): “For special histological types, we recommend following the St Gallen 2013 recommendations [20] that propose ET for endocrine responsive histologies”
Triple-negative breast cancer molecular subtyping and treatment progress (2020, background): “Gallen International Breast Cancer Conference issued a new definition of breast cancer molecular subtypes: luminal A (ER/PR, HER2, Ki67 < 20%, with the percentage indicating the immunohistochemical staining results for patient samples), luminal B (ER/PR < 20%, HER2, Ki67 ≥ 20%); HER2 B2 (ER/PR, HER2”
Collective Invasion in Breast Cancer Requires a Conserved Basal Epithelial Program (2013, methodology): “Using consensus guidelines, we then assigned these specimens to breast cancer subtypes based on their ER, PR, HER2/Neu, and Ki-67 status, as assayed by immunohistochemistry (Goldhirsch et al., 2013).”
Breast Cancer—Epidemiology, Risk Factors, Classification, Prognostic Markers, and Current Treatment Strategies—An Updated Review (2021, methodology): “Gallen’s 2013 guidelines the IHC-based surrogate subtype classification was recommended for clinical decision making [179].”
Clinical implications of the intrinsic molecular subtypes of breast cancer. (2015, neutral): “anti-HER2 therapy) in early breast cancer [8].”