4th International Consensus Conference on Advanced Breast Cancer (ABC4), Lisbon, November 4, 2017^[*]

Abstract

The fourth international advanced breast cancer consensus conference (ABC4) on the diagnosis and treatment of advanced breast cancer (ABC) headed by Professor Fatima Cardoso was once again held in Lisbon on November 2 – 4, 2017. To simplify matters, the abbreviation ABC will be used hereinafter in the text. In clinical practice, the abbreviation corresponds to metastatic breast cancer or locally far-advanced disease. This year the focus was on new developments in the treatment of ABC. Topics discussed included the importance of CDK4/6 inhibition in hormone receptor (HR)-positive ABC, the use of dual antibody blockade to treat HER2-positive ABC, PARP inhibition in triple-negative ABC and the potential therapeutic outcomes. Another major area discussed at the conference was BRCA-associated breast cancer, the treatment of cerebral metastasis, and individualized treatment decisions based on molecular testing (so-called precision medicine). As in previous years, close cooperation with representatives from patient organizations from around the world is an important aspect of the ABC conference. This cooperation was reinforced and expanded at the ABC4 conference. A global alliance was founded at the conclusion of the consensus conference, which aims to promote and coordinate the measures considered necessary by patient advocates worldwide. Because the panel of experts was composed of specialists from all over the world, it was inevitable that the ABC consensus also reflected country-specific features. As in previous years, a team of German breast cancer specialists who closely followed the consensus voting of the ABC panelists in Lisbon and intensively discussed the votes has therefore commented on the consensus in the context of the current German guidelines on the diagnosis and treatment of breast cancer [1], [2] used in clinical practice in Germany. The ABC consensus is based on the votes of the ABC panelists in Lisbon.

Key words

ABC4 - local advanced and metastasized breast cancer (ABC) - HR-positive and HER2-negative ABC - BRCA-mutated ABC - CNS metastasis - personalized medicine

• References/Literatur

• 1 Janni W. für die AGO Kommission Mamma. AGO Empfehlungen „Diagnostik und Therapie von Patientinnen mit frühem Brustkrebs“. Update 2018 Online: http://www.ago-online.de last access: 14.03.2018
• 2 Konsultationsfassung S3-Leitlinie „Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms“. Langversion 0.4.1. – August 2017. AWMF-Register-Nr. 032-045OL. Online: http://www.awmf.org last access: 13.11.2017, additional: www.leitlinienprogramm-onkologie.de last access: 13.11.2017
• 3 Cardoso F, Costa A, Norton L. et al. 1st International consensus guidelines for advanced breast cancer (ABC 1). Breast 2012; 21: 242-252 doi:10.1016/j.breast.2012.03.003
• 4 Cardoso F, Costa A, Norton L. et al. ESO-ESMO 2nd international consensus guidelines for advanced breast cancer (ABC2). Breast 2014; 23: 489-502
• 5 Cardoso F, Costa A, Senkus E. et al. ESO-ESMO 3rd international consensus guidelines for advanced breast cancer (ABC3). Breast 2017; 31: 244-259
• 6 Online: http://www.esmo.org/Guidelines/ESMO-Guidelines-Methodology last access: 13.11.2017
• 7 Paluch-Shimon S, Pagani O, Partridge AH. et al. ESO-ESMO 3rd international consensus guidelines for breast cancer in young women (BCY3). Breast 2017; 35: 203-217
• 8 Baselga J, Campone M, Piccart M. et al. Everolimus in postmenopausal hormone-receptor-positive advanced breast cancer. N Engl J Med 2012; 366: 520-529
• 9 Beck JT, Hortobagyi GN, Campone M. et al. Everolimus plus exemestane as first-line therapy in HR⁺, HER2⁻ advanced breast cancer in BOLERO-2. Breast Cancer Res Treat 2014; 143: 459-467
• 10 Kornblum NS, Manola J, Klein P. et al. PrECOG 0102: A randomized, double-blind phase II trial of fulvestrant plus everolimus or placebo in post-menopausal women with hormone-receptor positive, HER2-negative metastatic breast cancer resistant to aromatase inhibitor therapy. San Antonio Breast Cancer Symposium 2016; Abstract S1-02.
• 11 Finn RS, Martin M, Rugo HS. et al. Palbociclib and letrozole in advanced breast cancer. N Engl J Med 2016; 375: 1925-1936
• 12 Hortobagyi GN, Stemmer SM, Burris HA. et al. Ribociclib as first-line-therapy for HR-positive, advanced breast cancer. N Engl J Med 2016; 375: 1738-1748
• 13 Hortobagyi GN. Updated results from MONALEESA-2, a phase 3 trial of first-line Ribociclib + letrozole in hormone receptor-positive, HER2-negative advanced breast cancer. JCO ASCO 2017; 35 (15S): #1038
• 14 Christofanilli M, Turner NC, Bonarenko I. et al. Fulvestrant plus palbociclib versus fulvestrant plus placebo for treatment of hormone-receptor-positive, HER2-negative metastasic breast cancer that progressed on previous endocrine therapy (PALOMA-3): final analysis of the multicentre, double-blind, phase 3 randomised controlled trial. Lancet Oncol 2016; 17: 425-439
• 15 Harbeck N, Iyer S, Turner N. et al. Quality of life with palbociclib plus fulvestrant in previously treated hormone receptor-positive, HER2-negative metastatic breast cancer: patient-reported outcomes from the PALOMA-3 trial. Ann Oncol 2016; 27: 1047-1054
• 16 Robertson JFR, Bondarenko IM, Trishkina E. et al. Fulvestrant 500 mg versus anastrozole 1 mg for hormone receptor-positive advanced breast cancer (FALCON): an international, randomised, double-blind, phase 3 trial. Lancet 2016; 388: 2997-3005
• 17 Hahnen E, Lederer B, Hauke J. et al. Germline mutation status, pathological complete response, and disease-free survival in triple-negative breast cancer: secondary analysis of the GeparSixto randomized clinical trial. JAMA Oncol 2017; 3: 1378-1385
• 18 Litton J, Rugo H, Ettl J. et al. EMBRACA: A phase 3 trial comparing talazoparib, an oral PARP inhibitor, to physicianʼs choice of therapy in patients with advanced germline BRCA-mutation breast cancer. San Antonio Breast Cancer Symposium 2017; Abstract GS6-07.
• 19 Vasen HF, Watson P, Mecklin JP. et al. New clinical criteria for hereditary nonpolyposis colorectal cancer (HNPCC, Lynch syndrome) proposed by the International Collaborative group on HNPCC. Gastroenterology 1999; 116: 1453-1456
• 20 Online: http://www.fda.gov/NewsEvents last access: 03.12.2017
• 21 Bartsch R, Berghoff A, Pluschnig U. et al. Impact of anti-HER2 therapy on overall survival in HER2-overexpressing breast cancer patients with brain metastases. Br J Cancer 2012; 106: 25-31
• 22 Bartsch R, Berghoff AS, Preusser M. Breast cancer brain metastases responding to primary systemic therapy with T-DM1. J Neurooncol 2014; 116: 205-206
• 23 Bachelot T, Romieu G, Campone M. et al. Lapatinib plus capecitabine in patients with previously untreated brain metastases from HER2-positive metastatic breast cancer (LANDSCAPE): a single-group phase 2 study. Lancet Oncol 2013; 14: 64-71
• 24 Montemurro F, Ellis P, Delaloge S. et al. Safety and efficacy of trastuzumab emtansin in 399 patients with central nervous system metastases: exploratory subgroup analysis from the KAMILLA study. San Antonio Breast Cancer Symposium 2016; Abstract P1-12-10.
• 25 Von Minckwitz G, Procter M, de Azambuja E. et al. Adjuvant pertuzumab and trastuzumab in early HER2-positive breast cancer. N Engl J Med 2017; 377: 122-131
• 26 Martin M, Holmes FA, Ejletersen B. et al. Neratinib after trastuzumab-based adjuvant therapy in HER2-positive breast cancer (ExteNET): 5-year analysis of a randomised, double-blind, placebo-controlled phase 3 trial. Lancet Oncol 2017; 18: 1688-1700
• 27 Online: http://www.onkopedia.com/de/news/komplementaere-und-alternative-therapieverfahren last access: 12.11.2017
• 28 Untch M, Harbeck N, Thomssen C. Colloquium 2017/2018. Oktober 2017. München: Lukon Verlag; 2017
• 29 Dykewicz CA. Summary of the guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. Clin Infect Dis 2001; 33: 139-144