Understanding breast cancer complexity to improve patient outcomes: The St Gallen International Consensus Conference for the Primary Therapy of Individuals with Early Breast Cancer 2023

The 18th St Gallen International Breast Cancer Conference held in March 2023, in Vienna, Austria, assessed significant new findings for local and systemic therapies for early breast cancer with a focus on the evaluation of multimodal treatment options. The emergence of more effective, innovative age...

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Published in:	Annals of oncology Vol. 34; no. 11; pp. 970 - 986
Main Authors:	Curigliano, G., Burstein, H.J., Gnant, M., Loibl, S., Cameron, D., Regan, M.M., Denkert, C., Poortmans, P., Weber, W.P., Thürlimann, B., Aebi, S., Al-Foheidi, M., André, F., Anikusko, M., Badwe, R., Barrio, A.V., Barrios, C., Bergh, J., Bonnefoi, H., Bretel Morales, D., Brucker, S., Caldas, C., Cardoso, F., Cardoso, M.J., Carey, L., Chia, S., Coles, C., Cortes, J., de Boniface, J., Delaloge, S., DeMichele, A., Fastner, G., Fitzal, F., Francis, P., Gamal, H., Gentilini, O., Gradishar, W., Gulluoglu, B., Harbeck, N., Heil, J., Huang, C.-S.H., Huober, J., Jiang, Z., Kaidar-Person, O., Kok, M., Lee, E.-S., Loi, S., Martin, M., Meattini, I., Morrow, M., Partridge, A., Penault-Llorca, F., Piccart, M., Pierce, L., Regan, M., Reis-Filho, J., Rubio, I., Rugo, H., Rutgers, E., Saura, C., Senkus, E., Shao, Z., Singer, C., Spanic, T., Thuerlimann, B., Toi, M., Tolaney, S., Turner, N., Tutt, A., Vrancken Peeters, M.-J., Watanabe, T., Weber, W., Wildiers, H., Xu, B.
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-11-2023
Subjects:	Adjuvants, Immunologic - therapeutic use Breast Neoplasms - drug therapy Carcinoma, Lobular Combined Modality Therapy early breast cancer ER-positive breast cancer surgery Female HER2-positive breast cancer Humans Medicin och hälsovetenskap Neoadjuvant Therapy radiation therapy triple-negative breast cancer early breast cancer triple-negative breast cancer ER-positive breast cancer surgery HER2-positive breast cancer radiation therapy
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Summary:	The 18th St Gallen International Breast Cancer Conference held in March 2023, in Vienna, Austria, assessed significant new findings for local and systemic therapies for early breast cancer with a focus on the evaluation of multimodal treatment options. The emergence of more effective, innovative agents in both the preoperative (primary or neoadjuvant) and post-operative (adjuvant) settings has underscored the pivotal role of a multidisciplinary approach in treatment decision making, particularly when selecting systemic therapy for an individual patient. The importance of multidisciplinary discussions regarding the clinical benefits of interventions was explicitly emphasized by the consensus panel as an integral part of developing an optimal treatment plan with the ‘right’ degree of intensity and duration. The panelists focused on controversies surrounding the management of common ductal/no special type and lobular breast cancer histology, which account for the vast majority of breast tumors. The expert opinion of the panelists was based on interpretations of available data, as well as current practices in their professional environments, personal and socioeconomic factors affecting patients, and cognizant of varying reimbursement and accessibility constraints around the world. The panelists strongly advocated patient participation in well-designed clinical studies whenever feasible. With these considerations in mind, the St Gallen Consensus Conference aims to offer guidance to clinicians regarding appropriate treatments for early-stage breast cancer and assist in balancing the realistic trade-offs between treatment benefit and toxicity, enabling patients and clinicians to make well-informed choices through a shared decision-making process. •The optimal estrogen receptor (ER) threshold for initiating endocrine therapy remains controversial.•Treatments for ER-positive breast cancer (BC) are personalized based on tumor stage, subtype, menopausal status.•For stage I (TNM), HER2-positive BC, the panelists continue to favor paclitaxel/trastuzumab as the recommended regimen.•Regardless of response to neoadjuvant chemotherapy plus pembrolizumab, the panelists favored adjuvant pembrolizumab.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Instructional Material/Guideline-3 content type line 23
ISSN:	0923-7534 1569-8041 1569-8041
DOI:	10.1016/j.annonc.2023.08.017