%0 Journal Article
%T Systemic Therapy for Patients With Advanced Human Epidermal Growth Factor Receptor 2每Positive Breast Cancer: ASCO Clinical Practice Guideline Update Summary
%A Nancy E. Davidson
%A Sarah Temin
%A Sharon H. Giordano
%J General Information | Journal of Oncology Practice
%D 2018
%R https://doi.org/10.1200/JOP.18.00290
%X The goal of this update is to provide oncologists, other health care practitioners, patients, and caregivers with recommendations regarding optimal management of patients with human epidermal growth factor receptor 2 (HER2)每positive metastatic breast cancer.1 ASCO first published two evidence-based clinical practice guidelines on optimal management of patients with HER2-positive metastatic breast cancer in 2014.2,3 The goal of this 2018 guideline update is to provide oncologists and other clinicians with current recommendations regarding the treatment of patients with HER2-positive metastatic breast cancer. The current 2018 update assesses whether the 2014 recommendations remain valid. No additional evidence was identified that would warrant a change. A complete list of previous recommendations, the updated brain metastases1 and HER2-positive breast cancer guidelines,2 and additional information are available at www.asco.org/breast-cancer-guidelines. Patient information is available at www.cancer.net. THE BOTTOM LINE Systemic Therapy for Patients With Advanced Human Epidermal Growth Factor Receptor 2每Positive Breast Cancer: ASCO Clinical Practice Guideline Update Guideline Question What is the optimal medical therapy for advanced human epidermal growth factor receptor 2 (HER2)每positive breast cancer, specifically HER2-targeted therapy, either alone or in combination with chemotherapy and/or endocrine therapy? Target Population Individuals with advanced HER2-positive breast cancer Target Audience Medical oncologists, radiation oncologists, surgeons, oncology nurses, and patients/caregivers Methods A systematic review of the literature was performed and relevant evidence was evaluated for inclusion into this updated clinical practice guideline using the signals approach. Recommendations Clinicians should recommend HER2-targeted therapy每based combinations for first-line treatment, except for highly selected patients with estrogen receptor每positive or progesterone receptor每positive and HER2-positive disease, for whom clinicians may use endocrine therapy alone (Type: evidence based; Evidence quality: high; Strength of recommendation: strong). If a patient＊s HER2-positive advanced breast cancer has progressed during or after first-line HER2-targeted therapy, clinicians should recommend second-line HER2-targeted therapy每 based treatment (Type: evidence based; Evidence quality: high; Strength of recommendation: strong). If a patient＊s HER2-positive advanced breast cancer has progressed during or after second-line or greater HER2-targeted treatment, clinicians
%U http://ascopubs.org/doi/full/10.1200/JOP.18.00290