激素受体阳性/ her2阴性转移性乳腺癌(EVOLVE):意大利德尔菲共识报告。

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
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引用次数: 0

摘要

背景:激素受体阳性,HER2阴性(HR+/HER2-)转移性乳腺癌(mBC)患者的治疗前景不断扩大,导致国际指南未涵盖新的“灰色地带”的出现,其中治疗决策特别具有挑战性。方法:关于HR+/HER2 mBC管理的16项相关声明由执行委员会制定,并由国际公认的BC领域专家组成的科学委员会进行验证。随后,在2024年5月至2024年6月期间,通过改进的德尔菲法对50名意大利肿瘤学家进行了调查,以获取他们对拟议陈述的同意和不同意率。结果:16项结论全部达成一致,其中4项与CDK4/6抑制剂和内分泌治疗的耐药和敏感性有关,6项与HR+/HER2- mBC生物标志物有关,6项与HR+/HER2- mBC治疗方法有关。小组对最相关的结果进行了批判性和全面的讨论,特别是关于同意程度较低的陈述(从85.4%到100%不等)。结论:由于药典的扩展,对其分子决定因素的更好理解以及对患者选择的生物标志物的验证,目前HR+/HER2- mBC的治疗正在重塑。这一共识解决了与治疗决策有关的最具争议的问题,并在所有声明中达成一致。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The evolving landscape of hormone receptor-positive/HER2-negative metastatic breast cancer (EVOLVE): an Italian Delphi consensus report.

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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