ABC2 Consensus Guidelines Published
medwireNews: The Advanced Breast Cancer Second International Consensus Conference (ABC2) guidelines have been released by the European School of Oncology (ESO) and the European Society of Medical Oncology (ESMO).
The ABC2 guidelines, developed at the 2013 consensus conference, have been published as an Open Access article simultaneously in the Annals of Oncology and The Breast and are endorsed by other organisations, including the European Society of Breast Cancer Specialists (EUSOMA).
The general guideline statement highlights the importance of oncology nursing within multidisciplinary care teams for ABC patients, as well as the need for early palliative care and the use of validated, patient-reported instruments to aid reporting of symptoms and treatment adverse events.
The researchers also emphasise that patient age should not be used as the sole reason to determine type or intensity of treatment.
“Treatment should not be withheld just because a patient is elderly; nor should young patients be over-treated,” said ABC2 co-chair Eric Winer, from the Dana-Farber Cancer Institute in Boston, Massachusetts, USA, in a press release.
For the first time, the guidelines discuss management of locally advanced breast cancer (LABC), including inoperable and inflammatory disease.
Patients with inflammatory LABC are recommended to undergo similar treatment to those with noninflammatory LABC but should receive systemic therapy first. Most LABC patients should also undergo mastectomy with axillary dissection, but not immediate reconstruction, in addition to locoregional radiotherapy even when pathological complete remission is achieved with systemic therapy.
Guidance has also been given on the treatment of liver metastases, malignant pleural effusion and chest wall and nodal recurrence, as well as the care of male ABC patients and patients with BRCA-associated, triple-negative or endocrine-resistant disease.
Finally, updates have been released on the management of oestrogen receptor-positive/HER2-negative ABC and for HER2-positive and -negative ABC, plus the use of surgery for patients whose primary tumour is stage IV at diagnosis.
“Our plea for a strong commitment of all involved parties (academia, pharmaceutical industry, independent funding sources, and advocacy groups) to develop well-designed, high-quality multidisciplinary (involving other issues than drug-development) trials for ABC remains of critical importance,” the guidance authors conclude.
“Many questions are still unanswered, related to management strategies, optimal drug use, and individualized treatment (based on predictive markers and eventually new technologies aiming at better characterization of the individual tumour).”
The ABC3 guidelines will be created following the ABC Third International Consensus Conference, to be held in Portugal in November 2015.
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By Lynda Williams, Senior medwireNews Reporter