Federica Miglietta, Maria Grazia Razeti, Aldo Caltavituro, Arianna Dri, Carmine Valenza, Giampaolo Bianchini, Laura Biganzoli, Andrea Botticelli, Michele Caruso, Saverio Cinieri, Carmen Criscitiello, Carmine De Angelis, Michelino De Laurentis, Lucia Del Mastro, Sabino De Placido, Marzia Del Re, Maria Vittoria Dieci, Alessandra Fabi, Daniele Generali, Alessandra Gennari, Lorenzo Gerratana, Mario Giuliano, Matteo Lambertini, Umberto Malapelle, Luca Malorni, Icro Meattini, Ida Paris, Giancarlo Pruneri, Claudio Zamagni, Alberto Zambelli, Francois Clement Bidard, Valentina Guarneri, Fabio Puglisi, Giuseppe Curigliano, Grazia Arpino
{"title":"The evolving landscape of hormone receptor-positive/HER2-negative metastatic breast cancer (EVOLVE): an Italian Delphi consensus report.","authors":"Federica Miglietta, Maria Grazia Razeti, Aldo Caltavituro, Arianna Dri, Carmine Valenza, Giampaolo Bianchini, Laura Biganzoli, Andrea Botticelli, Michele Caruso, Saverio Cinieri, Carmen Criscitiello, Carmine De Angelis, Michelino De Laurentis, Lucia Del Mastro, Sabino De Placido, Marzia Del Re, Maria Vittoria Dieci, Alessandra Fabi, Daniele Generali, Alessandra Gennari, Lorenzo Gerratana, Mario Giuliano, Matteo Lambertini, Umberto Malapelle, Luca Malorni, Icro Meattini, Ida Paris, Giancarlo Pruneri, Claudio Zamagni, Alberto Zambelli, Francois Clement Bidard, Valentina Guarneri, Fabio Puglisi, Giuseppe Curigliano, Grazia Arpino","doi":"10.1016/j.critrevonc.2025.104793","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The expanding treatment landscape for patients with hormone receptor-positive, HER2-negative (HR+/HER2-) metastatic breast cancer (mBC) has led to the emergence of new \"grey areas\" not covered by international guidelines, where treatment decision making is particularly challenging.</p><p><strong>Methods: </strong>Sixteen relevant statements regarding the management of HR+/HER2 mBC were formulated by an Executive Board and validated by a Scientific Board, composed by internationally recognized experts in the field of BC. Subsequently, 50 Italian oncologists were surveyed between May 2024 and June 2024 through the modified Delphi method, in order to capture their rate of agreement and disagreement on the proposed statements.</p><p><strong>Results: </strong>The consensus was reached for all 16 statements: 4 were related to resistance and sensitivity to CDK4/6 inhibitors and endocrine therapy, 6 to biomarkers for HR+/HER2- mBC, and 6 to treatment algorithm of HR+/HER2- mBC. The Panel critically and comprehensively discussed the most relevant results, especially regarding the statements with lower level of agreement (which ranged from 85.4% to 100%).</p><p><strong>Conclusions: </strong>The treatment of HR+/HER2- mBC is currently being reshaped due to the expansion of its pharmacopoeia, the better understanding of its molecular determinants and the validation of biomarkers for patient selection. This consensus addressed the most controversial questions related to treatment decision and reached the agreement in all statements.</p>","PeriodicalId":93958,"journal":{"name":"Critical reviews in oncology/hematology","volume":" ","pages":"104793"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical reviews in oncology/hematology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.critrevonc.2025.104793","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Background: The expanding treatment landscape for patients with hormone receptor-positive, HER2-negative (HR+/HER2-) metastatic breast cancer (mBC) has led to the emergence of new "grey areas" not covered by international guidelines, where treatment decision making is particularly challenging.
Methods: Sixteen relevant statements regarding the management of HR+/HER2 mBC were formulated by an Executive Board and validated by a Scientific Board, composed by internationally recognized experts in the field of BC. Subsequently, 50 Italian oncologists were surveyed between May 2024 and June 2024 through the modified Delphi method, in order to capture their rate of agreement and disagreement on the proposed statements.
Results: The consensus was reached for all 16 statements: 4 were related to resistance and sensitivity to CDK4/6 inhibitors and endocrine therapy, 6 to biomarkers for HR+/HER2- mBC, and 6 to treatment algorithm of HR+/HER2- mBC. The Panel critically and comprehensively discussed the most relevant results, especially regarding the statements with lower level of agreement (which ranged from 85.4% to 100%).
Conclusions: The treatment of HR+/HER2- mBC is currently being reshaped due to the expansion of its pharmacopoeia, the better understanding of its molecular determinants and the validation of biomarkers for patient selection. This consensus addressed the most controversial questions related to treatment decision and reached the agreement in all statements.
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