For nearly half a century, various oncology guidelines issued by the American Society of Clinical Oncology (ASCO) have become the most important reference source for oncologists around the world to formulate treatment plans. In 2014, ASCO published a clinical practice guideline on advanced human epidermal growth factor receptor (HER2) negative breast cancer chemotherapy and targeted therapy online. Based on evidence-based medicine evidence, this guideline recommends the best treatment plan (including chemotherapy and targeted therapy) for HER2-negative advanced breast cancer (locally advanced breast cancer that cannot reach R0 resection or metastatic breast cancer), as well as the side effects and side effects of treatment methods. Validity details.

150302 The guideline systematically reviewed the relevant medical literature and experimental data from January 1993 to May 2013, providing evidence for the formulation of the guideline. The main suggestions in the article are as follows:

For women with hormone receptor-positive advanced breast cancer, in addition to immediate life-threatening lesions or resistance to hormone therapy, hormone therapy should be the first-line standard treatment.
Different chemotherapeutics should be administered sequentially, rather than combined, to reduce side effects and maintain quality of life.
Doctors and patients should jointly decide on chemotherapy regimens, taking the previous treatment plan, side effects, timing, other chronic diseases (for example, heart disease), and patient wishes into consideration, because there is no single best chemotherapy.
When there is an immediate life-threatening disease or severe symptoms, consider bevacizumab as a single-agent chemotherapy. (Bevacizumab has been shown to shrink tumors and delay disease progression in some trials, but it cannot prolong overall survival. Moreover, the US FDA has not approved bevacizumab for breast cancer treatment.)
Except everolimus, other targeted drugs should not be shared with or substituted for chemotherapy. (Everolimus combined with hormone therapy exemestane is approved for the early treatment of women with hormone receptor-positive breast cancer).
Palliative care should be started as early as possible and provided during the ongoing diagnosis and treatment process. Palliative supportive treatment should be provided as soon as possible when no further chemotherapy options are available. When formulating a treatment plan, doctors should take the patient as the center and fully consider the quality of life. However, the potential harm of palliative care may make the patient give up hope, but it can be handled and resolved through effective communication and appropriate hospice care.
Since advanced breast cancer is not yet cured, doctors should encourage eligible patients to participate in clinical trials to benefit from promising experimental treatments.
The traditional clinicopathological staging is still closely related to the prognosis, and even plays a decisive role. Although most localized cancers can achieve long-term disease-free survival, the 5-year survival rate for metastatic breast cancer is only 24%, and most of them cannot be cured. Especially for HER2-negative advanced breast cancer due to the lack of effective targeted therapy drugs, it is more important to formulate a scientific treatment plan.

Original link:

http://www.asco.org/press-center/asco-issues-new-guideline-treating-patients-advanced-her2-negative-breast-cancer

http://www.guideline.gov/content.aspx?id=48623&search=therapy+for+women+with+her2%C2%AD-negative+or+unknown+advanced+breast+cancer