Expert UK consensus on the definition of high risk of recurrence in HER2-negative early breast cancer: A modified Delphi panel.

Autor: Copson ER; Cancer Sciences Academic Unit, University of Southampton, Southampton, UK. Electronic address: E.Copson@soton.ac.uk., Abraham JE; Precision Breast Cancer Institute, Department of Oncology, University of Cambridge, Cambridge, UK; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Braybrooke JP; University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK., Cameron D; Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK., McIntosh SA; Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK., Michie CO; Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK., Okines AFC; The Royal Marsden NHS Foundation Trust, London, UK., Palmieri C; The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK; Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK., Raja F; University College London Hospitals NHS Foundation Trust, London, UK; North Middlesex University Hospital, North Middlesex University Hospital NHS Trust, London, UK., Roylance R; University College London Hospitals NHS Foundation Trust, London, UK; NIHR University College London Hospitals Biomedical Research Centre, London, UK., Spensley S; Musgrove Park Hospital, Somerset NHS Foundation Trust, Taunton, UK.
Jazyk: angličtina
Zdroj: Breast (Edinburgh, Scotland) [Breast] 2023 Dec; Vol. 72, pp. 103582. Date of Electronic Publication: 2023 Sep 17.
DOI: 10.1016/j.breast.2023.103582
Abstrakt: Background: There is currently no standardised definition for patients at high risk of recurrence of human epidermal growth factor receptor 2 (HER2)-negative early breast cancer (eBC; stages 1-3) after surgery. This modified Delphi panel aimed to establish expert UK consensus on this definition, separately considering hormone receptor (HR)-positive and triple-negative (TN) patients.
Methods: Over three consecutive rounds, results were collected from 29, 24 and 22 UK senior breast cancer oncologists and surgeons, respectively. The first round aimed to determine key risk factors in each patient subgroup; subsequent rounds aimed to establish appropriate risk thresholds. Consensus was pre-defined as ≥70% of respondents.
Results: Expert consensus was achieved on need to assess age, tumour size, tumour grade, number of positive lymph nodes, inflammatory breast cancer and risk prediction tools in all HER2-negative patients. There was additional agreement on use of tumour profiling tests and biomarkers in HR-positive patients, and pathologic complete response (pCR) status in TN patients. Thresholds for high recurrence risk were subsequently agreed. In HR-positive patients, these included age <35 years, tumour size >5 cm (as independent risk factors); tumour grade 3 (independently and combined with other high-risk factors); number of positive nodes ≥4 (independently) and ≥1 (combined). For TN patients, the following thresholds reached consensus, both independently and in combination with other factors: tumour size >2 cm, tumour grade 3, number of positive nodes ≥1.
Conclusions: The results may be a valuable reference point to guide recurrence risk assessment and decision-making after surgery in the HER2-negative eBC population.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ERC: Consultant: AstraZeneca, Lilly, Novartis, Pfizer, Roche, Sanofi; Speaker fees: Novartis; Research grant: AstraZeneca; Educational grant: Daiichi Sankyo; Provision of research equipment: seca; Congress support: Novartis, Roche. JEA: Research grant: AstraZeneca; Speaker fees: Eisai, Pfizer. JPB: Nothing to disclose. DC: Consultant: AstraZeneca, Exact Sciences, Lilly, Novartis, Roche; Research funding: Exact Sciences, Novartis, Roche. SAMcI: Consultant: Lilly, MSD, Roche; Fees for non-CME services: BD; Congress support: Lilly, Roche; Research funding: Novartis. COM: Nothing to disclose. AFCO: Research funding: Pfizer, Roche; Consultant: AstraZeneca, Pfizer, Roche, Seagen; Speaker fees: AstraZeneca, Gilead, Lilly, Pfizer, Seagen; Congress support: AstraZeneca; Lilly. CP: Consultant: AstraZeneca, Daiichi Sankyo, Ellipses Pharma, Exact Sciences, Gilead, Lilly, Novartis, Pfizer, Seagen; Research funding: Daiichi Sankyo, Exact Sciences, Pfizer, Seagen; Congress support: Gilead, Roche. FR: Consultant: AstraZeneca, Daiichi Sankyo, Gilead, Lilly, MSD, Novartis, Pfizer, Roche; Congress support: AstraZeneca, MSD, Novartis, Roche. RR: Consultant: AstraZeneca, Daiichi Sankyo, G1 Therapeutics, IQVIA, Lilly, Pfizer; Congress support: BMS, Daiichi Sankyo, Roche; Grants to institution: NIHR. SS: Consultant: Lilly, Pfizer.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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