- The American Society of Clinical Oncology (ASCO) has issued new clinical practice guidelines to update their 2016 clinical practice guidelines on selection of adjuvant chemotherapy for early breast cancer, and adjuvant targeted therapy for human epidermal growth factor receptor 2 (HER2)-positive breast cancer.
Why this matters
- New clinical practice guidelines by an expert panel specifically for use of capecitabine, pertuzumab, and neratinib in early breast cancer (stages I-IIIc).
- Qualitative review of newly published phase 3 trials by an ASCO expert panel.
- Funding: None disclosed.
Main recommendations for early-stage breast cancer
- Clinicians may offer up to 6-8 cycles of adjuvant capecitabine to patients with early-stage HER2-negative breast cancer receiving standard anthracycline- and taxane-based preoperative therapy (evidence quality: intermediate; strength of recommendation: moderate).
- Clinicians may add 1 year of adjuvant pertuzumab to trastuzumab-based combination therapy in those with high-risk HER2+ breast cancer (evidence quality: high; strength of recommendation: moderate).
- Clinicians may offer extended adjuvant therapy with neratinib after trastuzumab in patients with HER2+ breast cancer (evidence quality: high; strength of recommendation: moderate).
- Because neratinib causes significant diarrhea, diarrhea prophylaxis should be used.