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6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7).

ABSTRACT: This manuscript describes the Advanced Breast Cancer (ABC) international consensus guidelines updated at the last two ABC international consensus conferences (ABC 6 in 2021, virtual, and ABC 7 in 2023, in Lisbon, Portugal), organized by the ABC Global Alliance. It provides the main recommendations on how to best manage patients with advanced breast cancer (inoperable locally advanced or metastatic), of all breast cancer subtypes, as well as palliative and supportive care. These guidelines are based on available evidence or on expert opinion when a higher level of evidence is lacking. Each guideline is accompanied by the level of evidence (LoE), grade of recommendation (GoR) and percentage of consensus reached at the consensus conferences. Updated diagnostic and treatment algorithms are also provided. The guidelines represent the best management options for patients living with ABC globally, assuming accessibility to all available therapies. Their adaptation (i.e. resource-stratified guidelines) is often needed in settings where access to care is limited.

SUBMITTER: Cardoso F

PROVIDER: S-EPMC11231614 | biostudies-literature | 2024 May

REPOSITORIES: biostudies-literature

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6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7).

Cardoso Fatima F Paluch-Shimon Shani S Schumacher-Wulf Eva E Matos Leonor L Gelmon Karen K Aapro Matti S MS Bajpai Jyoti J Barrios Carlos H CH Bergh Jonas J Bergsten-Nordström Elizabeth E Biganzoli Laura L Cardoso Maria João MJ Carey Lisa A LA Chavez-MacGregor Mariana M Chidebe Runcie R Cortés Javier J Curigliano Giuseppe G Dent Rebecca A RA El Saghir Nagi S NS Eniu Alexandru A Fallowfield Lesley L Francis Prudence A PA Franco Millan Sandra X SX Gilchrist Jenny J Gligorov Joseph J Gradishar William J WJ Haidinger Renate R Harbeck Nadia N Hu Xichun X Kaur Ranjit R Kiely Belinda B Kim Sung-Bae SB Koppikar Smruti S Kuper-Hommel Marion J J MJJ Lecouvet Frédéric E FE Mason Ginny G Mertz Shirley A SA Mueller Volkmar V Myerson Claire C Neciosup Silvia S Offersen Birgitte V BV Ohno Shinji S Pagani Olivia O Partridge Ann H AH Penault-Llorca Frédérique F Prat Aleix A Rugo Hope S HS Senkus Elzbieta E Sledge George W GW Swain Sandra M SM Thomssen Christoph C Vorobiof Daniel A DA Vuylsteke Peter P Wiseman Theresa T Xu Binghe B Costa Alberto A Norton Larry L Winer Eric P EP

Breast (Edinburgh, Scotland) 20240528

This manuscript describes the Advanced Breast Cancer (ABC) international consensus guidelines updated at the last two ABC international consensus conferences (ABC 6 in 2021, virtual, and ABC 7 in 2023, in Lisbon, Portugal), organized by the ABC Global Alliance. It provides the main recommendations on how to best manage patients with advanced breast cancer (inoperable locally advanced or metastatic), of all breast cancer subtypes, as well as palliative and supportive care. These guidelines are ba ...[more]

PMID: 38896983

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Project description:BK polyomavirus (BKPyV) remains a significant challenge after kidney transplantation. International experts reviewed current evidence and updated recommendations according to Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Risk factors for BKPyV-DNAemia and biopsy-proven BKPyV-nephropathy include recipient older age, male sex, donor BKPyV-viruria, BKPyV-seropositive donor/-seronegative recipient, tacrolimus, acute rejection, and higher steroid exposure. To facilitate early intervention with limited allograft damage, all kidney transplant recipients should be screened monthly for plasma BKPyV-DNAemia loads until month 9, then every 3 mo until 2 y posttransplant (3 y for children). In resource-limited settings, urine cytology screening at similar time points can exclude BKPyV-nephropathy, and testing for plasma BKPyV-DNAemia when decoy cells are detectable. For patients with BKPyV-DNAemia loads persisting >1000 copies/mL, or exceeding 10 000 copies/mL (or equivalent), or with biopsy-proven BKPyV-nephropathy, immunosuppression should be reduced according to predefined steps targeting antiproliferative drugs, calcineurin inhibitors, or both. In adults without graft dysfunction, kidney allograft biopsy is not required unless the immunological risk is high. For children with persisting BKPyV-DNAemia, allograft biopsy may be considered even without graft dysfunction. Allograft biopsies should be interpreted in the context of all clinical and laboratory findings, including plasma BKPyV-DNAemia. Immunohistochemistry is preferred for diagnosing biopsy-proven BKPyV-nephropathy. Routine screening using the proposed strategies is cost-effective, improves clinical outcomes and quality of life. Kidney retransplantation subsequent to BKPyV-nephropathy is feasible in otherwise eligible recipients if BKPyV-DNAemia is undetectable; routine graft nephrectomy is not recommended. Current studies do not support the usage of leflunomide, cidofovir, quinolones, or IVIGs. Patients considered for experimental treatments (antivirals, vaccines, neutralizing antibodies, and adoptive T cells) should be enrolled in clinical trials.

Dataset Information

6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7).

Publications

6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7).

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