Introduction
➤ The purpose of this guideline update is to gather and examine the
evidence published since the 2014 guideline
a
and offer a series of
updated recommendations for advanced HER2-negative breast cancer,
if warranted.
➤ Note that while this guideline provides recommendations for chemo-
and targeted therapy for patients with HER2-negative metastatic
breast cancer that is either endocrine-pretreated or hormone
receptor-negative, a companion guideline
b
provides endocrine therapy
and targeted therapy recommendations, including CDK 4/6 and PI3
kinase inhibition, for hormone receptor-positive metastatic breast
cancer patients.
a
Partridge AH et al. J Clin Oncol. 2014 Oct 10;32(29):3307-29
b
Burstein HJ et al. J Clin Oncol. 2021 July 29;39(35):3959-3977
Treatment
New Recommendation from 2022 Guideline Rapid Recommendation
Update
➤ Patients with HER2 IHC 1+ or 2+ and ISH negative metastatic breast
cancer who have received at least one prior chemotherapy for
metastatic disease, and if HR+ are refractory to endocrine therapy,
should be offered treatment with trastuzumab deruxtecan. (Strong
recommendation; EB-B-M)