Tailoring neoadjuvant systemic therapy in breast cancer: "The advent of a personalized approach"-The Breast-Gynecological and Immuno-Oncology International Cancer Conference (BGICC) consensus and recommendations

Hesham Elghazaly¹, Hamdy A Azim², Hope S Rugo³, David Cameron⁴, Sandra M Swain⁵, Giuseppe Curigliano⁶, Nadia Harbeck⁷, Debu Tripathy⁸, Banu Arun⁸, Matti Aapro⁹, Martine Piccart¹⁰, Fatima Cardoso¹¹, Joseph Gligorov¹², Hagar Elghazawy¹, Nagi S El Saghir¹³, Frederique Penault-Llorca¹⁴, Edith A Perez¹⁵, Philip Poortmans¹⁶, Hany Abdelaziz¹, Heba M El-Zawahry², Loay Kassem², Mohamed Sabry¹, Giuseppe Viale¹⁷, Sana Al-Sukhun¹⁸, Neven Gado¹, Jessica W T Leung¹⁹, Lobna Ezz Elarab¹, Maria João Cardoso²⁰, Khaled Abdel Karim¹, Meteb Foheidi²¹, Merit M Elmaadawy²², Pierfranco Conte^{23

24}, Ashraf S M Selim²⁵, Alaa Kandil²⁶, Rasha M Kamal²⁵, Ruslan M Paltuev²⁷, Valentina Guarneri^{23

24}, Omalkhair Abulkhair²⁸, Omar Zakaria²⁹, Mehra Golshan³⁰, Roberto Orecchia³¹, Manal ElMahdy³², Ahmed M Abdel-Aziz³³, Nermean Bahie Eldin¹

Affiliations

¹ Department of Clinical Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
² Department of Clinical Oncology, Kasr Alainy School of Medicine, Cairo University, Giza, Egypt.
³ Department of Medicine, University of California San Francisco Comprehensive Cancer Center, San Francisco, California, USA.
⁴ Edinburgh Cancer Research Centre, Institute of Genetics and Cancer, University of Edinburgh and National Health Service Lothian, Edinburgh, UK.
⁵ Georgetown Lombardi Comprehensive Cancer Center, MedStar Health, Washington, District of Columbia, USA.
⁶ Department of Oncology and Hemato-Oncology, European Institute of Oncology, IRCCS, University of Milano, Milan, Italy.
⁷ Department of Obstetrics and Gynecology and Comprehensive Cancer Center Munich, Breast Center, Ludwig Maximilian University Hospital, Munich, Germany.
⁸ Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
⁹ Breast Center, Clinique de Genolier, Genolier, Switzerland.
¹⁰ Institut Jules Bordet and L'Université Libre de Bruxelles, Brussels, Belgium.
¹¹ Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal.
¹² Medical Oncology Department, L'Assistance Publique-Hôpitaux de Paris, Institute Universitaire de Cancérologie, Sorbonne Université, Paris, France.
¹³ Division of Hematology Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
¹⁴ National Institute of Health and Medical Research Unit 1240 "Molecular Imaging and Theranostic Strategies", Department of Pathology, Clermont Auvergne University, Center Jean Perrin, Clermont-Ferrand, France.
¹⁵ Department of Hematology and Oncology, Mayo Clinic, Jacksonville, Florida, USA.
¹⁶ Iridium Network and Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk-Antwerp, Belgium.
¹⁷ European Institute of Oncology, IRCCS, Milan, Italy.
¹⁸ Al Hyatt Oncology Practice, Amman, Jordan.
¹⁹ Department of Breast Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
²⁰ Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Faculdade de Medicina, Lisbon, Portugal.
²¹ College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Adult Medical Oncology, Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs-Western Region, Jeddah, Saudi Arabia.
²² Diagnostic Radiology Department, Mansoura University, Mansoura, Egypt.
²³ Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy.
²⁴ Division of Oncology, Istituto Oncologico Veneto-IRCCS, Padova, Italy.
²⁵ Diagnostic and Interventional Radiology Department, Cairo University, Giza, Egypt.
²⁶ Department of Clinical Oncology, Alexandria School of Medicine, Alexandria, Egypt.
²⁷ Department of Breast Tumours of Federal State Budgetary Institution "Petrov Research Institute of Oncology", Russian Association of Oncological Mammology, St Petersburg, Russia.
²⁸ Medical Oncology Department, Oncology Services, Alhabib Hospital, Riyad, Saudi Arabia.
²⁹ Department of Surgery, Cairo University, Cairo, Egypt.
³⁰ Department of Surgery, Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, Connecticut, USA.
³¹ Scientific Directorate, IRCCS European Institute of Oncology, University of Milan, Milan, Italy.
³² Department of Pathology, Ain Shams University, Cairo, Egypt.
³³ Department of Pathology, Faculty of Medicine, Cairo University, Giza, Egypt.

PMID: 38985794
DOI: 10.1002/cncr.35389

Free article

Tailoring neoadjuvant systemic therapy in breast cancer: "The advent of a personalized approach"-The Breast-Gynecological and Immuno-Oncology International Cancer Conference (BGICC) consensus and recommendations

Hesham Elghazaly et al. Cancer. 2024.

Free article

. 2024 Oct 1;130(19):3251-3271.

doi: 10.1002/cncr.35389. Epub 2024 Jul 10.

Authors

Affiliations

¹ Department of Clinical Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
² Department of Clinical Oncology, Kasr Alainy School of Medicine, Cairo University, Giza, Egypt.
³ Department of Medicine, University of California San Francisco Comprehensive Cancer Center, San Francisco, California, USA.
⁴ Edinburgh Cancer Research Centre, Institute of Genetics and Cancer, University of Edinburgh and National Health Service Lothian, Edinburgh, UK.
⁵ Georgetown Lombardi Comprehensive Cancer Center, MedStar Health, Washington, District of Columbia, USA.
⁶ Department of Oncology and Hemato-Oncology, European Institute of Oncology, IRCCS, University of Milano, Milan, Italy.
⁷ Department of Obstetrics and Gynecology and Comprehensive Cancer Center Munich, Breast Center, Ludwig Maximilian University Hospital, Munich, Germany.
⁸ Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
⁹ Breast Center, Clinique de Genolier, Genolier, Switzerland.
¹⁰ Institut Jules Bordet and L'Université Libre de Bruxelles, Brussels, Belgium.
¹¹ Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal.
¹² Medical Oncology Department, L'Assistance Publique-Hôpitaux de Paris, Institute Universitaire de Cancérologie, Sorbonne Université, Paris, France.
¹³ Division of Hematology Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
¹⁴ National Institute of Health and Medical Research Unit 1240 "Molecular Imaging and Theranostic Strategies", Department of Pathology, Clermont Auvergne University, Center Jean Perrin, Clermont-Ferrand, France.
¹⁵ Department of Hematology and Oncology, Mayo Clinic, Jacksonville, Florida, USA.
¹⁶ Iridium Network and Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk-Antwerp, Belgium.
¹⁷ European Institute of Oncology, IRCCS, Milan, Italy.
¹⁸ Al Hyatt Oncology Practice, Amman, Jordan.
¹⁹ Department of Breast Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
²⁰ Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Faculdade de Medicina, Lisbon, Portugal.
²¹ College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Adult Medical Oncology, Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs-Western Region, Jeddah, Saudi Arabia.
²² Diagnostic Radiology Department, Mansoura University, Mansoura, Egypt.
²³ Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy.
²⁴ Division of Oncology, Istituto Oncologico Veneto-IRCCS, Padova, Italy.
²⁵ Diagnostic and Interventional Radiology Department, Cairo University, Giza, Egypt.
²⁶ Department of Clinical Oncology, Alexandria School of Medicine, Alexandria, Egypt.
²⁷ Department of Breast Tumours of Federal State Budgetary Institution "Petrov Research Institute of Oncology", Russian Association of Oncological Mammology, St Petersburg, Russia.
²⁸ Medical Oncology Department, Oncology Services, Alhabib Hospital, Riyad, Saudi Arabia.
²⁹ Department of Surgery, Cairo University, Cairo, Egypt.
³⁰ Department of Surgery, Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, Connecticut, USA.
³¹ Scientific Directorate, IRCCS European Institute of Oncology, University of Milan, Milan, Italy.
³² Department of Pathology, Ain Shams University, Cairo, Egypt.
³³ Department of Pathology, Faculty of Medicine, Cairo University, Giza, Egypt.

PMID: 38985794
DOI: 10.1002/cncr.35389

Abstract

Background: The management of early breast cancer (BC) has witnessed an uprise in the use of neoadjuvant therapy and a remarkable reshaping of the systemic therapy postneoadjuvant treatment in the last few years, with the evolution of many controversial clinical situations that require consensus.

Methods: During the 14th Breast-Gynecological and Immuno-Oncology International Cancer Conference held in Egypt in 2022, a panel of 44 BC experts from 13 countries voted on statements concerning debatable challenges in the neo/adjuvant treatment setting. The recommendations were subsequently updated based on the most recent data emerging. A modified Delphi approach was used to develop this consensus. A consensus was achieved when ≥75% of voters selected an answer.

Results and conclusions: The consensus recommendations addressed different escalation and de-escalation strategies in the setting of neoadjuvant therapy for early BC. The recommendations recapitulate the available clinical evidence and expert opinion to individualize patient management and optimize therapy outcomes. Consensus was reached in 63% of the statements (52/83), and the rationale behind each statement was clarified.

Keywords: HER2‐positive breast cancer; adjuvant therapy; breast cancer; hormone receptor‐positive breast cancer; neoadjuvant therapy; triple‐negative breast cancer.

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References

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Tailoring neoadjuvant systemic therapy in breast cancer: "The advent of a personalized approach"-The Breast-Gynecological and Immuno-Oncology International Cancer Conference (BGICC) consensus and recommendations

Affiliations

Tailoring neoadjuvant systemic therapy in breast cancer: "The advent of a personalized approach"-The Breast-Gynecological and Immuno-Oncology International Cancer Conference (BGICC) consensus and recommendations

Authors

Affiliations

Abstract

References

REFERENCES

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Research Materials

Miscellaneous