“ASCO Issues HER2-Negative Breast Cancer Guide?” By Charles Bankhead, MedPage Today.

Editorial Note: After reviewing medical literature from 1993 through May 2013, the American Society of Clinical Oncology (ASCO) developed a new set of clinical guidelines for patients with advanced HER2-negative breast cancer. The review included findings from 59 randomized clinical trials and 20 systematic reviews or meta-analyses that were focused on this subset of breast cancer patients. While it did not identify specific drugs, it reinforced strategies to be used in the clinical care of patients.

The guideline panel recommended that:

  • Except in a few circumstances, hormone therapy should be offered as first-line therapy for patients with advanced hormone receptor-positive breast cancer.
  • Chemotherapy should be administered sequentially, rather than in combination, to minimize adverse effects.
  • Bevacizumab (Avastin) should only be considered as single-agent therapy for patients who have immediately life-threatening disease or severe symptoms.
  • No other targeted agents should be used in combination with chemotherapy or as a replacement for chemotherapy (everolimus [Afinitor] has approval for use in combination with exemestane earlier stage, hormone receptor-positive disease).
  • Clinicians should initiate palliative care early and should offer it throughout the continuum of care.
  • Absent a cure for the disease, clinicians should encourage all eligible patients to participate in clinical trials.

The complete set of guidelines will be published in the Journal of Clinical Oncology and made available through the ASCO website. ASCO has developed patient information related to the guideline.

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