The Advanced Breast Cancer Fourth Consensus (ABC4) on diagnosis and treatment of advanced breast cancer (ABC) again took place in Lisbon, on November 2-4, 2017, and was chaired by Fatima Cardoso, MD, PhD. This year's contents focused very much on new developments in the treatment of ABC. For example, the significance of inhibition of cyclin-dependent kinases 4 and 6 (CDK4/6) in hormone receptor (HR)-positive ABC, of dual antibody blockade in human epidermal growth factor receptor 2 (HER2)-positive ABC, and of poly(ADP-ribose) polymerase (PARP) inhibition in triple-negative ABC, as well as the potential therapeutic consequences, were discussed. Other key issues were BRCA-associated breast cancer, treatment of brain metastases, and personalized therapy decision-making using molecular testing (so-called ‘precision medicine'). As in past years, an important objective of the ABC conference was cooperation with representatives of patient organizations from around the world. This cooperation was further intensified during the ABC4. Following the main conference, the ‘Global Alliance' was founded, with the goal of publicizing and coordinating measures necessary worldwide from the patient advocates' standpoint. - The ABC consensus inevitably cannot accommodate country-specific needs, due to the truly global expert panel. Therefore, a working group of German breast cancer experts commented - as in the past years - on the on-site voting results by the ABC panelists upon which the final ABC4 consensus will be based, with particular consideration of the German guidelines on diagnosis and treatment of breast cancer for everyday treatment in Germany.

Journal Section:
Editor's choice
Keywords:
ABC4, Advanced breast cancer, HR-positive/HER2-positive, <italic>BRCA</italic>-associated, Brain metastases, Personalized medicine
1.
Cardoso F, Costa A, Norton L, et al: 1st International consensus guidelines for advanced breast cancer (ABC 1). Breast 2012;21:242-252.
https://doi.org/10.1016/j.breast.2012.03.003
[PubMed]
2.
Cardoso F, Costa A, Norton L, et al: ESO-ESMO 2nd international consensus guidelines for advanced breast cancer (ABC2). Breast 2014;23:489-502.
[PubMed]
https://doi.org/10.1016/j.breast.2014.08.009
3.
Cardoso F, Costa A, Senkus E, et al: ESO-ESMO 3rd international consensus guidelines for advanced breast cancer (ABC3). Breast 2017;31:244-259.
[PubMed]
https://doi.org/10.1016/j.breast.2016.10.001
4.
www.esmo.org/Guidelines/ESMO-Guidelines-Methodology (last accessed November 13, 2017).
5.
Liedtke C, Thill M, Jackisch C, Thomssen C, Müller V, Janni W; on behalf of the AGO Breast Committee: AGO recommendations for the diagnosis and treatment of patients with early breast cancer: update 2017. Breast Care 2017;12:172-183.
[PubMed]
https://doi.org/10.1159/000477575
6.
Thill M, Liedtke C, Solomayer E-F, Müller V, Janni W, Schmidt M; on behalf of the AGO Breast Committee: AGO recommendations for the diagnosis and treatment of patients with advanced and metastatic breast cancer: update 2017. Breast Care 2017;12:184-191.
[PubMed]
https://doi.org/10.1159/000477576
7.
www.awmf.org (retrieved: 11/13/2017), www.leitlinienprogramm-onkologie.de, consultation version S3 guideline ‘Early detection, diagnostics, therapy and aftercare of breast cancer', long version 0.4.1., August 2017, AWMF registry no. 032-045OL.
8.
Paluch-Shimon S, Pagani O, Partridge AH, et al: ESO-ESMO 3rd international consensus guidelines for breast cancer in young women (BCY3). Breast 2017;35:203-217.
[PubMed]
https://doi.org/10.1016/j.breast.2017.07.017
9.
Baselga J, Campone M, Piccart M, et al: Everolimus in postmenopausal hormone-receptor-positive advanced breast cancer. N Engl J Med 2012;366:520-529.
[PubMed]
https://doi.org/10.1056/NEJMoa1109653
10.
Beck JT, Hortobagyi GN, Campone M, et al: Everolimus plus exemestane as first-line therapy in HR+, HER2- advanced breast cancer in BOLERO-2. Breast Cancer Res Treat 2014;143:459-467.
[PubMed]
https://doi.org/10.1007/s10549-013-2814-5
11.
Kornblum NS, Manola J, Klein P, et al: PrECOG 0102: a randomized, double-blind phase II trial of fulvestrant plus everolimus or placebo in post-menopausal women with hormone-receptor positive, HER2-negative metastatic breast cancer resistant to aromatase inhibitor therapy. SABCS 2016;abstr S1-02.
12.
Finn RS, Martin M, Rugo HS, et al: Palbociclib and letrozole in advanced breast cancer. N Engl J Med 2016;375:1925-1936.
[PubMed]
https://doi.org/10.1056/NEJMoa1607303
13.
Hortobagyi GN, Stemmer SM, Burris HA, et al: Ribociclib as first-line-therapy for HR-positive, advanced breast cancer. N Engl J Med 2016;375:1738-1748.
[PubMed]
https://doi.org/10.1056/NEJMoa1609709
14.
Hortobagyi GN: Updated results from MONALEESA-2, a phase 3 trial of first-line ribociclib + letrozole in hormone receptor-positive, HER2-negative advanced breast cancer. J Clin Oncol 2017;35(15S):1038.
15.
Christofanilli M, Turner NC, Bonarenko I, et al: Fulvestrant plus palbiciclib versus fulvestrant plus placebo for treatment of hormone-receptor-positive, HER2-negative metastasic breast cancer that progressed on previous endocrine therapy (PALOMA-3): final analysis of the multicentre, double-blind, phase 3 randomised controlled trial. Lancet Oncol 2016;17:425-439.
[PubMed]
https://doi.org/10.1016/S1470-2045(15)00613-0
16.
Harbeck N, Iyer S, Turner N, et al: Quality of life with palbociclib plus fulvestrant in previously treated hormone receptor-positive, HER2-negative metastatic breast cancer: patient-reported outcomes from the PALOMA-3 trial. Ann Oncol 2016;27:1047-1054.
[PubMed]
https://doi.org/10.1093/annonc/mdw139
17.
Robertson JF, Bondarenko IM, Trishkina E, et al: Fulvestrant 500 mg versus anastrozole 1 mg for hormone-receptor-positive advanced breast cancer (FALCON): an international, randomised, double-blind phase 3 trial. Lancet 2017;388:2997-3005.
[PubMed]
https://doi.org/10.1016/S0140-6736(16)32389-3
18.
Hahnen E, Lederer B, Hauke J, et al: Germline mutation status, pathological complete response, and disease-free survival in triple-negative breast cancer: secondary analysis of the GeparSixto randomized clinical trial. JAMA Oncol 2017;3:1378-1385.
[PubMed]
https://doi.org/10.1001/jamaoncol.2017.1007
19.
Vasen HF, Watson P, Mecklin JP, Lynch HT: New clinical criteria for hereditary nonpolyposis colorectal cancer (HNPCC, Lynch syndrome) proposed by the International Collaborative Group on HNPCC. Gastroenterology 1999;116:1453-1456.
[PubMed]
https://doi.org/10.1016/S0016-5085(99)70510-X
20.
www.fda.gov/NewsEvents (last accessed December 2017).
21.
Bartsch R, Berghoff A, Pluschnig U, et al: Impact of anti-HER2 therapy on overall survival in HER2-overexpressing breast cancer patients with brain metastases. Br J Cancer 2012;106:25-31.
[PubMed]
https://doi.org/10.1038/bjc.2011.531
22.
Bartsch R, Berghoff AS, Preusser M: Breast cancer brain metastases responding to primary systemic therapy with T-DM1. J Neurooncol 2014;116:205-206.
[PubMed]
https://doi.org/10.1007/s11060-013-1257-5
23.
Bachelot T, Romieu G, Campone M, et al: Lapatinib plus capecitabine in patients with previously untreated brain metastases from HER2-positive metastatic breast cancer (LANDSCAPE): a single-group phase 2 study. Lancet Oncol 2013;14:64-71.
[PubMed]
https://doi.org/10.1016/S1470-2045(12)70432-1
24.
Montemurro F, Ellis P, Delaloge S, et al: Safety and efficacy of trastuzumab emtansin in 399 patients with central nervous system metastases: exploratory subgroup analysis from the KAMILLA study. SABCS 2016;abstr P1-12-10.
25.
Von Minckwitz G, Procter M, de Azambuja E, et al: Adjuvant pertuzumab and trastuzumab in early HER2-positive breast cancer. N Engl J Med 2017;377:122-131.
[PubMed]
https://doi.org/10.1056/NEJMoa1703643
26.
Martin M, Holmes FA, Ejletersen B, et al: Neratinib after trastuzumab-based adjuvant therapy in HER2-positive breast cancer (ExteNET): 5-year analysis of a randomised, double-blind, placebo-controlled phase 3 trial. Lancet Oncol 2017;18:1688-1700.
[PubMed]
https://doi.org/10.1016/S1470-2045(17)30717-9
27.
www.oncopedia.com/de/news/komplementaere-und-alternative-therapieverfahren (last accessed November, 2017).
28.
Untch M, Harbeck N, Thomssen C: Colloquium Senologie 2017/2018, ed 1. München, Lukon, 2017.
29.
Dykewicz CA: Summary of the guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. Clin Infect Dis 2001;33:139-144.
[PubMed]
https://doi.org/10.1086/321805
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