ASCO Issues Guidelines on Treatments for Advanced-Stage HER2-Negative Breast Cancer

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The American Society of Clinical Oncology (ASCO) has put out new guidelines on treating women diagnosed with advanced-stage HER2-negative breast cancer. Except in a few cases, hormonal therapy instead of chemotherapy should be the first treatment given to women diagnosed with advanced-stage, hormone-receptor-positive, HER2-negative breast cancer.

The guidelines were published online on Sept. 2, 2014 by the Journal of Clinical Oncology. Read “Chemotherapy and Targeted therapy for Women With Human Epidermal Growth Factor Receptor 2-Negative (or unknown) Advanced Breast Cancer: American Society of Clinical Oncology Practice Guideline.”

ASCO is a national organization of oncologists and other cancer care providers. ASCO guidelines give doctors recommendations for treatments and testing that are supported by much credible research and experience.

The ASCO experts based the new guidelines on a review of research published between 1993 and 2014. Key recommendations are:

  • In most cases, hormonal therapy, rather than chemotherapy, should be the first treatment given to women diagnosed with advanced-stage, hormone-receptor-positive, HER2-negative breast cancer. The exceptions are if the disease is immediately life-threatening or if doctors are concerned that the cancer may be resistant to hormonal therapy.
  • Chemotherapy medicines should be given one at a time in sequence, rather than in combination. This means that you would get a full course of one chemotherapy medicine before you started another chemotherapy medicine. Giving chemotherapy in this way helps minimize severe side effects.
  • Chemotherapy with one medicine should continue until the cancer grows. No specific chemotherapy medicine has been shown to be better than another to treat advanced-stage HER2-negative breast cancer. The chemotherapy used should be based on any previous treatments, as well as a woman’s other medical conditions, side effects, and preferences.
  • Avastin (chemical name: bevacizumab), a targeted therapy, should only be given to women who have severe symptoms or immediately life-threatening disease. No other targeted therapy medicines should be given at the same time as chemotherapy or used as a replacement for chemotherapy.
  • Doctors should offer patients palliative care early and should continue to offer it throughout breast cancer treatment. Palliative care is a team-based approach in which a group of professionals – including doctors, nurses, social workers, psychiatrists, dieticians, and chaplains -- focus on relieving the pain, anxiety, and stress that cancer can cause.
  • As there is no cure for advanced-stage breast cancer yet, doctors should encourage all eligible women to enroll in a clinical trial that is appropriate for their unique situations.

If you’ve been diagnosed with advanced-stage HER2-negative breast cancer, it’s good to know that you have several treatment options available. If one treatment stops working, there are others you can try. If you’re willing to participate in a clinical trial, you may have even more options available. Together, you and your doctor can determine the best treatments for you.

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