Tailoring neoadjuvant systemic therapy in breast cancer: “The advent of a personalized approach”—The Breast‐Gynecological and Immuno‐Oncology International Cancer Conference (BGICC) consensus and recommendations

Author:

Elghazaly Hesham1,Azim Hamdy A.2,Rugo Hope S.3,Cameron David4,Swain Sandra M.5,Curigliano Giuseppe6ORCID,Harbeck Nadia7,Tripathy Debu8,Arun Banu8ORCID,Aapro Matti9,Piccart Martine10,Cardoso Fatima11,Gligorov Joseph12ORCID,Elghazawy Hagar1ORCID,El Saghir Nagi S.13ORCID,Penault‐Llorca Frederique14,Perez Edith A.15ORCID,Poortmans Philip16,Abdelaziz Hany1,El‐Zawahry Heba M.2,Kassem Loay2,Sabry Mohamed1,Viale Giuseppe17,Al‐Sukhun Sana18,Gado Neven1,Leung Jessica W. T.19,Ezz Elarab Lobna1,Cardoso Maria João20,Abdel Karim Khaled1,Foheidi Meteb21,Elmaadawy Merit M.22,Conte Pierfranco2324ORCID,Selim Ashraf S. M.25,Kandil Alaa26,Kamal Rasha M.25,Paltuev Ruslan M.27,Guarneri Valentina2324,Abulkhair Omalkhair28,Zakaria Omar29,Golshan Mehra30,Orecchia Roberto31,ElMahdy Manal32,Abdel‐Aziz Ahmed M.33,Eldin Nermean Bahie1

Affiliation:

1. Department of Clinical Oncology Faculty of Medicine Ain Shams University Cairo Egypt

2. Department of Clinical Oncology Kasr Alainy School of Medicine Cairo University Giza Egypt

3. Department of Medicine University of California San Francisco Comprehensive Cancer Center San Francisco California USA

4. Edinburgh Cancer Research Centre Institute of Genetics and Cancer University of Edinburgh and National Health Service Lothian Edinburgh UK

5. Georgetown Lombardi Comprehensive Cancer Center MedStar Health Washington District of Columbia USA

6. Department of Oncology and Hemato‐Oncology European Institute of Oncology IRCCS University of Milano Milan Italy

7. Department of Obstetrics and Gynecology and Comprehensive Cancer Center Munich Breast Center Ludwig Maximilian University Hospital Munich Germany

8. Department of Breast Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USA

9. Breast Center Clinique de Genolier Genolier Switzerland

10. Institut Jules Bordet and L'Université Libre de Bruxelles Brussels Belgium

11. Breast Unit Champalimaud Clinical Center/Champalimaud Foundation Lisbon Portugal

12. Medical Oncology Department L'Assistance Publique‐Hôpitaux de Paris Institute Universitaire de Cancérologie Sorbonne Université Paris France

13. Division of Hematology Oncology Department of Internal Medicine American University of Beirut Medical Center Beirut Lebanon

14. National Institute of Health and Medical Research Unit 1240 “Molecular Imaging and Theranostic Strategies” Department of Pathology Clermont Auvergne University Center Jean Perrin Clermont‐Ferrand France

15. Department of Hematology and Oncology Mayo Clinic Jacksonville Florida USA

16. Iridium Network and Faculty of Medicine and Health Sciences University of Antwerp Wilrijk‐Antwerp Belgium

17. European Institute of Oncology IRCCS Milan Italy

18. Al Hyatt Oncology Practice Amman Jordan

19. Department of Breast Imaging Division of Diagnostic Imaging The University of Texas MD Anderson Cancer Center Houston Texas USA

20. Breast Unit Champalimaud Clinical Center Champalimaud Foundation Faculdade de Medicina Lisbon Portugal

21. College of Medicine King Saud Bin Abdulaziz University for Health Sciences Adult Medical Oncology Princess Noorah Oncology Center King Abdulaziz Medical City Ministry of National Guard Health Affairs‐Western Region Jeddah Saudi Arabia

22. Diagnostic Radiology Department Mansoura University Mansoura Egypt

23. Department of Surgery, Oncology, and Gastroenterology University of Padova Padova Italy

24. Division of Oncology Istituto Oncologico Veneto–IRCCS Padova Italy

25. Diagnostic and Interventional Radiology Department Cairo University Giza Egypt

26. Department of Clinical Oncology Alexandria School of Medicine Alexandria Egypt

27. Department of Breast Tumours of Federal State Budgetary Institution “Petrov Research Institute of Oncology” Russian Association of Oncological Mammology St Petersburg Russia

28. Medical Oncology Department Oncology Services Alhabib Hospital Riyad Saudi Arabia

29. Department of Surgery Cairo University Cairo Egypt

30. Department of Surgery Yale Comprehensive Cancer Center Yale University School of Medicine New Haven Connecticut USA

31. Scientific Directorate IRCCS European Institute of Oncology University of Milan Milan Italy

32. Department of Pathology Ain Shams University Cairo Egypt

33. Department of Pathology Faculty of Medicine Cairo University Giza Egypt

Abstract

AbstractBackgroundThe management of early breast cancer (BC) has witnessed an uprise in the use of neoadjuvant therapy and a remarkable reshaping of the systemic therapy postneoadjuvant treatment in the last few years, with the evolution of many controversial clinical situations that require consensus.MethodsDuring the 14th Breast‐Gynecological and Immuno‐Oncology International Cancer Conference held in Egypt in 2022, a panel of 44 BC experts from 13 countries voted on statements concerning debatable challenges in the neo/adjuvant treatment setting. The recommendations were subsequently updated based on the most recent data emerging. A modified Delphi approach was used to develop this consensus. A consensus was achieved when ≥75% of voters selected an answer.Results and ConclusionsThe consensus recommendations addressed different escalation and de‐escalation strategies in the setting of neoadjuvant therapy for early BC. The recommendations recapitulate the available clinical evidence and expert opinion to individualize patient management and optimize therapy outcomes. Consensus was reached in 63% of the statements (52/83), and the rationale behind each statement was clarified.

Publisher

Wiley

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