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      Call for Papers: Supportive Care - Essential for Modern Oncology

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      About Oncology Research and Treatment: 2.0 Impact Factor I 3.2 CiteScore I 0.521 Scimago Journal & Country Rank (SJR)

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      St. Gallen/Vienna 2021: A Brief Summary of the Consensus Discussion on Customizing Therapies for Women with Early Breast Cancer

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          Abstract

          Because of the COVID-19 pandemic, the 2021 St. Gallen/Vienna Consensus Conference on Early Breast Cancer Treatment Standards had to be held virtually. Despite the challenge of convening global contributors to both the conference itself as well as the important Consensus Panel, the scientific committee and the organizers managed to organize a well-received scientific conference, and also the panel discussion was well received in the worldwide scientific community, as indicated by numerous positive feedbacks already within the first 24 h. The virtual format was unusual, but opened the door for new elements such as Consensus questions proposed from the audience, but also live audience interaction on both days − the Consensus was split into 2 parts in order to accommodate as many time zones globally as possible, leading to almost a doubling of discussion time compared to previous meetings. Also, about 3,400 participants from over 100 countries and all continents came together, including many colleagues who could attend for the first time from world regions with restrictions that so far did not allow the travel to Vienna. Traditionally, the Panel votings and discussions were preceded by 3 days of high-level live-discussions about the lectures that were available on demand already a week before. Also, all the lectures and live discussions in mini-panels are made available online for at least 6 months ( https://www.oncoconferences.ch/events/bcc-2021/). The traditional panel votings were once more moderated by Eric Winer from Harvard and included interactive elements such as audience votings and audience questions, presented by Michael Gnant. This rapid report by the editors-in-chief of Breast Care summarizes the results of the 2021 international panel votings with respect to locoregional and systemic treatment as a quick news update for our readers and clearly does not intend to replace the official St. Gallen Consensus publication that will follow shortly in Annals of Oncology.

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          Breast cancer

          Nadia Harbeck, Frederique Penault-Llorca, Javier Cortés … (2019)
          Breast cancer is the most frequent malignancy in women worldwide and is curable in ~70-80% of patients with early-stage, non-metastatic disease. Advanced breast cancer with distant organ metastases is considered incurable with currently available therapies. On the molecular level, breast cancer is a heterogeneous disease; molecular features include activation of human epidermal growth factor receptor 2 (HER2, encoded by ERBB2), activation of hormone receptors (oestrogen receptor and progesterone receptor) and/or BRCA mutations. Treatment strategies differ according to molecular subtype. Management of breast cancer is multidisciplinary; it includes locoregional (surgery and radiation therapy) and systemic therapy approaches. Systemic therapies include endocrine therapy for hormone receptor-positive disease, chemotherapy, anti-HER2 therapy for HER2-positive disease, bone stabilizing agents, poly(ADP-ribose) polymerase inhibitors for BRCA mutation carriers and, quite recently, immunotherapy. Future therapeutic concepts in breast cancer aim at individualization of therapy as well as at treatment de-escalation and escalation based on tumour biology and early therapy response. Next to further treatment innovations, equal worldwide access to therapeutic advances remains the global challenge in breast cancer care for the future.
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            Breast cancer

            Michael Gnant, Nadia Harbeck (2017)
            Breast cancer is one of the three most common cancers worldwide. Early breast cancer is considered potentially curable. Therapy has progressed substantially over the past years with a reduction in therapy intensity, both for locoregional and systemic therapy; avoiding overtreatment but also undertreatment has become a major focus. Therapy concepts follow a curative intent and need to be decided in a multidisciplinary setting, taking molecular subtype and locoregional tumour load into account. Primary conventional surgery is not the optimal choice for all patients any more. In triple-negative and HER2-positive early breast cancer, neoadjuvant therapy has become a commonly used option. Depending on clinical tumour subtype, therapeutic backbones include endocrine therapy, anti-HER2 targeting, and chemotherapy. In metastatic breast cancer, therapy goals are prolongation of survival and maintaining quality of life. Advances in endocrine therapies and combinations, as well as targeting of HER2, and the promise of newer targeted therapies make the prospect of long-term disease control in metastatic breast cancer an increasing reality.
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              Estimating the Benefits of Therapy for Early Stage Breast Cancer The St Gallen International Consensus Guidelines for the Primary Therapy of Early Breast Cancer 2019

              Harold J Burstein, Giuseppe Curigliano, Sibylle Loibl … (2019)
              The 17th St. Gallen International Breast Cancer Conference 2019 in Vienna, Austria reviewed substantial new evidence on loco-regional and systemic therapies for early breast cancer. Treatments were assessed in light of their intensity, duration and side-effects, estimating the magnitude of clinical benefit according to stage and biology of the disease. The Panel acknowledged that for many patients, the impact of adjuvant therapy or the adherence to specific guidelines may have modest impact on the risk of breast cancer recurrence or overall survival. For that reason, the Panel explicitly encouraged clinicians and patients to routinely discuss the magnitude of benefit for interventions as part of the development of the treatment plan. The guidelines focus on common ductal and lobular breast cancer histologies arising in generally healthy women. Special breast cancer histologies may need different considerations, as do individual patients with other substantial health considerations. The panelists’ opinions reflect different interpretation of available data and expert opinion where is lack of evidence and sociocultural factors in their environment such as availability of and access to medical service, economic resources and reimbursement issues. Panelists encourage patient participation in well-designed clinical studies whenever available. With these caveats in mind, the St Gallen consensus conference seeks to provide guidance to clinicians on appropriate treatments for early stage breast cancer and guidance for weighing the realistic tradeoffs between treatment and toxicity so that patients and clinical teams can make well-informed decisions on the basis of an honest reckoning of the magnitude of clinical benefit.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Breast Care (Basel)
                Journal ID (iso-abbrev): Breast Care (Basel)
                Journal ID (publisher-id): BRC
                Title: Breast Care
                Publisher: S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )
                ISSN (Print): 1661-3791
                ISSN (Electronic): 1661-3805
                Publication date (Print): April 2021
                Publication date (Electronic): 7 April 2021
                Volume: 16
                Issue: 2
                Pages: 135-143
                Affiliations
                [1] aDepartment of Gynaecology, Martin-Luther-University, Halle an der Saale, Germany
                [2] bDepartment of Internal Medicine, Division of Oncology, Medical University Graz, Graz, Austria
                [3] cBreast Center, Department of Obstetrics and Gynecology, University of Munich (LMU), Munich, Germany
                [4] dComprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
                Author notes
                Article
                Publisher ID: brc-0016-0135
                DOI: 10.1159/000516114
                PMC ID: 8089428
                PubMed ID: 34002112
                SO-VID: 8ac63234-07c0-4263-b8c5-bc9825e0a84f
                Copyright © Copyright © 2021 by S. Karger AG, Basel
                License:

                This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

                History
                Date received : 25 March 2021
                Date accepted : 25 March 2021
                Date: 2021
                Page count
                References: 6, Pages: 9
                Categories
                Subject: Review Article

                Keywords: early breast cancer,neoadjuvant systemic therapy,adjuvant treatment,endocrine therapy,chemotherapy,breast surgery,axillary surgery,radiotherapy,immunotherapy,survivorship,consensus
                Data availability:
                Keywords: early breast cancer, neoadjuvant systemic therapy, adjuvant treatment, endocrine therapy, chemotherapy, breast surgery, axillary surgery, radiotherapy, immunotherapy, survivorship, consensus

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