Advanced HR positive BC landscape: HT vs CT
•
International guidelines recommend to consider CT as 1L for a small subset of HR+HER2- breast
cancer patients
Rx Guideline Indication 1
Indication 2
NCCN
Endocrine refractory (No clinical benefit after 3
sequential endocrine therapy regimens)
Visceral crisis
ASCO
If there is concern regarding endocrine
resistance
Immediately life threatening disease
Canada
If there are concerns about upfront endocrine
resistance
Rapidly progressive or symptomatic visceral disease
ESMO
Proof of endocrine resistance
Visceral crisis:
“severe organ dysfunction as assessed by signs and
symptoms, laboratory studies, and rapid progression of
disease. Visceral crisis is not the mere presence of
visceral metastases but implies important visceral
compromise leading to a clinical indication for a more
rapidly efficacious therapy, particularly since another
treatment option at progression will probably not be
possible”
AGO
--
Acute life-threatening disease
SEOM
Once hormonal therapy is not working any
longer
Rapidly progressive visceral metastasis
Partridge et al JCO 2014; NCCN v2.2016; Pritchard Curr Oncol 2013; Joy et al Curr Onocl 2015; Cardoso et al Ann Oncol 2016; AGO v2016; Gavila et al CTO 2015
