Selection of Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer: ASCO Clinical Practice Guideline Focused Update
Selection of Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer: ASCO Clinical Practice Guideline Focused Update
复制标题
DOI：
10.1200/jco.2018.78.8604
复制
发表时间：
2018-08-10
影响因子：
45.3
通讯作者：
Giordano, Sharon H.
中科院分区：
文献类型：
--
作者：
Denduluri, Neelima;Chavez-MacGregor, Mariana;Giordano, Sharon H.
PurposeTo update key recommendations of the ASCO guidelines adaptation of the Cancer Care安大略guideline on the selection of optimal adjuvant chemotherapy regimens for early breast cancer and adjuvant targeted therapy for breast cancer.MethodsAn Expert Panel conducted targeted systematic literature reviews guideline guideline guideline guideline by a signals approach to identify new，潜在的实践-结果专家小组回顾了评价卡培他滨辅助治疗的III期临床试验，早期乳腺癌HER 2阴性乳腺癌患者完成标准术前蒽环类和紫杉烷类联合化疗，手术时有残留浸润性疾病;早期HER 2阳性乳腺癌患者在联合化疗和曲妥珠单抗基础上增加1年辅助帕妥珠单抗;以及来那替尼作为联合化疗和基于曲妥珠单抗的辅助治疗后早期HER 2阳性乳腺癌患者的扩展辅助治疗。在标准的蒽环类和紫杉烷类术前治疗后，可以提供多达6 - 8个周期的辅助卡培他滨。临床医生可以在高危、早期、HER 2阳性乳腺癌患者中，在以曲妥珠单抗为基础的联合化疗中增加1年的辅助帕妥珠单抗治疗。临床医生可在早期HER 2阳性乳腺癌患者中使用来那替尼扩展辅助治疗，以跟踪曲妥珠单抗治疗。来那替尼可引起严重腹泻，必须使用腹泻预防措施。更多信息可参见www.asco.org/breast-cancer-guidelines。
PurposeTo update key recommendations of the ASCO guideline adaptation of the Cancer Care Ontario guideline on the selection of optimal adjuvant chemotherapy regimens for early breast cancer and adjuvant targeted therapy for breast cancer.MethodsAn Expert Panel conducted targeted systematic literature reviews guided by a signals approach to identify new, potentially practice-changing data that might translate to revised practice recommendations.ResultsThe Expert Panel reviewed phase III trials that evaluated adjuvant capecitabine after completion of standard preoperative anthracycline- and taxane-based combination chemotherapy by patients with early-stage breast cancer HER2-negative breast cancer with residual invasive disease at surgery; the addition of 1 year of adjuvant pertuzumab to combination chemotherapy and trastuzumab for patients with early-stage, HER2-positive breast cancer; and the use of neratinib as extended adjuvant therapy for patients after combination chemotherapy and trastuzumab-based adjuvant therapy with early-stage, HER2-positive breast cancer.RecommendationsPatients with early-stage HER2-negative breast cancer with pathologic, invasive residual disease at surgery following standard anthracycline- and taxane-based preoperative therapy may be offered up to six to eight cycles of adjuvant capecitabine. Clinicians may add 1 year of adjuvant pertuzumab to trastuzumab-based combination chemotherapy in patients with high-risk, early-stage, HER2-positive breast cancer. Clinicians may use extended adjuvant therapy with neratinib to follow trastuzumab in patients with early-stage, HER2-positive breast cancer. Neratinib causes substantial diarrhea, and diarrhea prophylaxis must be used.Additional information can be found at www.asco.org/breast-cancer-guidelines.