Evidence-based treatment of metastatic breast cancer – 2006 recommendations by the AGO Breast Commission

2006 ◽  
Vol 42 (17) ◽  
pp. 2897-2908 ◽  
Author(s):  
Gunter von Minckwitz
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Metastatic Breast ◽  
Evidence Based ◽  
Evidence Based Treatment

scholarly journals Therapy Algorithms for the Diagnosis and Treatment of Patients with Early and Advanced Breast Cancer

Breast Care ◽  
2020 ◽  
Vol 15 (6) ◽  
pp. 608-618
Author(s):  
Andreas Schneeweiss ◽  
Ingo Bauerfeind ◽  
Tanja Fehm ◽  
Wolfgang Janni ◽  
Christoph Thomssen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Advanced Breast Cancer ◽  
Endocrine Therapy ◽  
Treatment Options ◽  
Metastatic Breast ◽  
Evidence Based ◽  
Complex Treatment ◽  
Her2 Positive ◽  
Evidence Based Treatment

<b><i>Background:</i></b> In order to offer optimal treatment approaches based on available evidence, the Commission Breast of the Working Group Gynecologic Oncology (AGO) of the German Cancer Society developed therapy algorithms for eight complex treatment situations in primary and advanced breast cancer. <b><i>Summary:</i></b> Therapy algorithms for the following complex treatment situations are outlined in this paper: (neo)adjuvant therapy of human epidermal growth factor receptor 2 (HER2)-positive breast cancer; axillary surgery and neoadjuvant chemotherapy; adjuvant endocrine therapy in premenopausal patients; adjuvant endocrine therapy in postmenopausal patients; hormone receptor (HR)-positive/HER2-negative metastatic breast cancer: strategies; HR-positive/HER2-negative metastatic breast cancer: endocrine-based first-line treatment; HER2-positive metastatic breast cancer: first to third-line; metastatic triple-negative breast cancer. <b><i>Key Messages:</i></b> The therapy options shown in these algorithms are based on the current AGO recommendations updated in January 2020 but cannot represent all evidence-based treatment options. Prior therapies, performance status, comorbidities, patient preference, etc. must be taken into account for the actual treatment choice. Therefore, in individual cases, other evidence-based treatment options not listed here may also be appropriate and justified.

scholarly journals AGO Recommendations for the Diagnosis and Treatment of Patients with Locally Advanced and Metastatic Breast Cancer: Update 2019

Breast Care ◽  
2019 ◽  
Vol 14 (4) ◽  
pp. 247-255 ◽  
Author(s):  
Marc Thill ◽  
Christian Jackisch ◽  
Wolfgang Janni ◽  
Volkmar Müller ◽  
Ute-Susann Albert ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Medical Oncology ◽  
Locally Advanced ◽  
Metastatic Breast ◽  
Diagnosis And Treatment ◽  
Evidence Based ◽  
Scientific Validity ◽  
Gynäkologische Onkologie ◽  
Radiologic Diagnostics

Every year the Breast Committee of the Arbeitsgemeinschaft Gynäkologische Onkologie (German Gynecological Oncology Group, AGO), a group of gynecological oncologists specialized in breast cancer and interdisciplinary members specialized in pathology, radiologic diagnostics, medical oncology, and radiation oncology, prepares and updates evidence-based recommendations for the diagnosis and treatment of patients with early and metastatic breast cancer. Every update is performed according to a documented rule-fixed algorithm, by thoroughly reviewing and scoring the recent publications for their scientific validity and clinical relevance. This current publication presents the 2019 update on the recommendations for metastatic breast cancer.

scholarly journals AGO Algorithms for the Treatment of Breast Cancer: Update 2021

2021 ◽  
Vol 81 (10) ◽  
pp. 1101-1111
Author(s):  
Andreas Schneeweiss ◽  
Peter A. Fasching ◽  
Tanja Fehm ◽  
Bernd Gerber ◽  
Christian Jackisch ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Performance Status ◽  
Treatment Options ◽  
Metastatic Breast ◽  
Treatment Decision ◽  
Evidence Based ◽  
Treatment Algorithms ◽  
Actual Treatment ◽  
Therapy Options ◽  
Evidence Based Treatment

AbstractTherapy options shown in the algorithms are based on the current AGO recommendations, but cannot represent all evidence-based treatment options, since prior therapies, performance status, comorbidities, patient preference, etc. must be taken into account for the actual treatment choice. In individual cases, other evidence-based treatment options may also be appropriate and justified. Regardless of approval status, the algorithms only take into account drugs that were available in Germany at the time the algorithm was last updated. Here we present the 2021 update of AGO treatment algorithms for early and metastatic breast cancer, which are intended to intensify structured treatment decision by providing reproducible and evidence-based treatment paths and may be helpful for a broad treatment landscape.

scholarly journals Metastatic Breast Cancer as a Chronic Disease: Evidence-Based Data on a Theoretical Concept

Breast Care ◽  
2019 ◽  
Vol 15 (3) ◽  
pp. 281-288
Author(s):  
Constanze Elfgen ◽  
Giacomo Montagna ◽  
Seraina Margaretha Schmid ◽  
Walter Bierbauer ◽  
Uwe Güth
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Chronic Disease ◽  
Progressive Disease ◽  
Case Fatality ◽  
Metastatic Breast ◽  
Theoretical Concept ◽  
First Year ◽  
Evidence Based ◽  
Entire Cohort

Background: We challenge the concept of metastatic breast cancer (MBC) as a chronic disease. Methods: We analyzed an unselected cohort of 367 patients who were diagnosed with MBC over a 22-year period (1990–2011). Results: In order to create a “chronic disease subgroup”, we separated those patients from the entire cohort in whom systemic therapy was not applied after the diagnosis of MBC (n = 53; 14.4%). Three hundred fourteen patients (85.6%) comprised the “chronic disease subgroup”. The vast majority of those patients (89.8%) died of progressive disease after a median metastatic disease survival (MDS) of 25 months. Twenty patients (6.4%) died of non-MBC-related causes (MDS 38.5 months). Approximately 1 in 4 patients (26.8%) died within the first year after the MBC diagnosis. The 3- and 5-year MDS rates were 35.4 and 16.2%, respectively. Only 12 patients (3.8%) were exceptional survivors (MDS >10 years). Conclusion: The term “chronic disease” might be appropriate in selected MBC cases, bringing MBC into alignment with “classical” chronic diseases such as diabetes and hypertension. However, most cases display fundamental differences with regard to temporal progression and above all the case fatality rate. More than 90% of patients in the “chronic disease subgroup” died of the disease with a MDS of 2–3 years (even those who underwent systemic palliative therapies). Doctors and patients might understand the term “chronic disease” differently. The term must be used sparingly and explained carefully in order to create a common level of communication based on a shared understanding which avoids awakening false hopes and fostering misleading expectations.

scholarly journals Building Evidence for Advocacy: Improved Services for MBC Patients in Romania

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 178s-178s
Author(s):  
R. Farcas ◽  
F. Pop ◽  
A. Melnic
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Metastatic Breast Cancer ◽  
Support Services ◽  
Service Provision ◽  
Metastatic Breast ◽  
Standard Of Care ◽  
Evidence Based ◽  
Information Materials

Background and context: More than 9000 women are diagnosed each year with breast cancer in Romania and one third of them will develop advanced disease. The metastatic breast cancer (MBC) management aims to optimize disease control while ensuring the best possible quality of life (QoL). In Romania, the new MBC treatments made possible longer survival, but social and psychological support is still extremely limited, and specific guidelines and standards for these services have not been developed. No study regarding distress level, quality of life and specific unmet need of metastatic breast cancer (MBC) patients in Romania was ever carried so no data are available to substantiate introduction of support services for these patients. An evidence based standard of care for support services, based on specific MBC patients needs, has to be developed to ensure an harmonization of support services in Romania. Aim: To improve quality of care for metastatic breast cancer (MBC) patients through the implementation of a standard of care for support services. Strategy/Tactics: The project uses an action research approach that starts with a qualitative study to identify both metastatic breast cancer (MBC) patients' specific needs (regarding information and support services when facing the challenges of diagnosis, treatment, and prognosis) and also their health and social providers' knowledge, experiences and perceptions about MBC. In-depths interviews will be performed with both patients and providers followed by data analysis. Based on the identified needs and literature, specific information materials for metastatic breast cancer (MBC) patients and support services guidelines will be developed. To build support, the materials (the study report, the information materials and the guidelines) will be disseminated among providers and patients through a Web page, a workshop with medical providers representatives from hospitals in the northwest region of Romania, presentation in different scientific events and collaboration with the other cancer patient associations in Romania. A policy proposal regarding the introduction and use of specific support services guidelines within the standard of care for metastatic breast cancer patients in Romania will be developed and presented to the Ministry of Health. Outcomes: An evidence based standard of care for support services and adequate information materials will create a basis for improved service provision for MBC patients; implementing a standard of care in the daily routine of service provision for MBC patients will support health and social providers to ensure better communication and patient empowerment that will have a direct impact on the treatment's efficiency as it increases patients' participation; it will also help MBC patients to better cope with the disease, to make personal decisions regarding treatment options and also to participate to the improvement of their quality of life.

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