Abstract
St Gallen Expert Consensus meetings update evidence on treatment of early breast cancer every 2 years and interpret its significance for treatment of individual patients. Such interpretation is controversial. Clinical decisions cannot, however, be postponed, and the harms of failing to tailor treatment must be balanced against those of overinterpretation. Since the ninth meeting in January 2005, an extraordinary year of progress has significantly changed the landscape in breast cancer therapy. The panel in January recommended a fundamental change in selection of adjuvant systemic therapy, giving prime attention to endocrine responsiveness. Primarily, three categories were acknowledged: endocrine responsive in which the primary treatment should be endocrine, endocrine non-responsive in which endocrine therapy should not be used, and an intermediate group for which both endocrine and other therapies should be offered. Secondarily, three risk groups were defined: low, intermediate, and high, slightly modifying the previous classification. In June 2005, three trials, supported in December by a fourth, demonstrated the additional contribution of targeted therapy with trastuzumab in appropriately selected patients. Reports from several trials strengthened the evidence supporting the inclusion of taxanes, though controversy persists concerning their use in endocrine-responsive disease. This commentary midway between St Gallen meetings, therefore, emphasizes how new information influences algorithms for selecting adjuvant therapy in a rapidly changing environment.
| Original language | English |
|---|---|
| Pages (from-to) | 1772-1776 |
| Number of pages | 5 |
| Journal | Annals of Oncology |
| Volume | 17 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 2006 |
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Keywords
- Adjuvant therapy
- Breast cancer
- Endocrine responsiveness
- Tailored therapies
ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
First - Select the target : Better choice of adjuvant treatments for breast cancer patients. / Goldhirsch, Aron; Coates, A. S.; Gelber, R. D.; Glick, J. H.; Thürlimann, B.; Senn, H. J.
In: Annals of Oncology, Vol. 17, No. 12, 12.2006, p. 1772-1776.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - First - Select the target
T2 - Better choice of adjuvant treatments for breast cancer patients
AU - Goldhirsch, Aron
AU - Coates, A. S.
AU - Gelber, R. D.
AU - Glick, J. H.
AU - Thürlimann, B.
AU - Senn, H. J.
PY - 2006/12
Y1 - 2006/12
N2 - St Gallen Expert Consensus meetings update evidence on treatment of early breast cancer every 2 years and interpret its significance for treatment of individual patients. Such interpretation is controversial. Clinical decisions cannot, however, be postponed, and the harms of failing to tailor treatment must be balanced against those of overinterpretation. Since the ninth meeting in January 2005, an extraordinary year of progress has significantly changed the landscape in breast cancer therapy. The panel in January recommended a fundamental change in selection of adjuvant systemic therapy, giving prime attention to endocrine responsiveness. Primarily, three categories were acknowledged: endocrine responsive in which the primary treatment should be endocrine, endocrine non-responsive in which endocrine therapy should not be used, and an intermediate group for which both endocrine and other therapies should be offered. Secondarily, three risk groups were defined: low, intermediate, and high, slightly modifying the previous classification. In June 2005, three trials, supported in December by a fourth, demonstrated the additional contribution of targeted therapy with trastuzumab in appropriately selected patients. Reports from several trials strengthened the evidence supporting the inclusion of taxanes, though controversy persists concerning their use in endocrine-responsive disease. This commentary midway between St Gallen meetings, therefore, emphasizes how new information influences algorithms for selecting adjuvant therapy in a rapidly changing environment.
AB - St Gallen Expert Consensus meetings update evidence on treatment of early breast cancer every 2 years and interpret its significance for treatment of individual patients. Such interpretation is controversial. Clinical decisions cannot, however, be postponed, and the harms of failing to tailor treatment must be balanced against those of overinterpretation. Since the ninth meeting in January 2005, an extraordinary year of progress has significantly changed the landscape in breast cancer therapy. The panel in January recommended a fundamental change in selection of adjuvant systemic therapy, giving prime attention to endocrine responsiveness. Primarily, three categories were acknowledged: endocrine responsive in which the primary treatment should be endocrine, endocrine non-responsive in which endocrine therapy should not be used, and an intermediate group for which both endocrine and other therapies should be offered. Secondarily, three risk groups were defined: low, intermediate, and high, slightly modifying the previous classification. In June 2005, three trials, supported in December by a fourth, demonstrated the additional contribution of targeted therapy with trastuzumab in appropriately selected patients. Reports from several trials strengthened the evidence supporting the inclusion of taxanes, though controversy persists concerning their use in endocrine-responsive disease. This commentary midway between St Gallen meetings, therefore, emphasizes how new information influences algorithms for selecting adjuvant therapy in a rapidly changing environment.
KW - Adjuvant therapy
KW - Breast cancer
KW - Endocrine responsiveness
KW - Tailored therapies
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UR - http://www.scopus.com/inward/citedby.url?scp=33845369142&partnerID=8YFLogxK
U2 - 10.1093/annonc/mdl398
DO - 10.1093/annonc/mdl398
M3 - Article
C2 - 17071934
AN - SCOPUS:33845369142
VL - 17
SP - 1772
EP - 1776
JO - Annals of Oncology
JF - Annals of Oncology
SN - 0923-7534
IS - 12
ER -