259P - Adherence to International ESO-ESMO (ABC) guide-lines in HER2-ve metastatic breast cancer (MBC) patients (pts) – Preliminary results of the GIM 13...

Date 11 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Breast Cancer
Presenter Marina Cazzaniga
Citation Annals of Oncology (2017) 28 (suppl_5): v74-v108. 10.1093/annonc/mdx365
Authors M. Cazzaniga1, G. Mustacchi2, M. Giordano3, O. Garrone4, M. Donadio5, L. del mastro6, L. Livi7, C. Natoli8, A. Michelotti9, A. Turletti10, R. Ferdinando11, M. De Laurentiis12, P. Marchetti13, M. Montemurro14, E. Romagnoli15, S. De Placido16, P. Pronzato17, L. Biganzoli18, G. Bisagni19, E. Bria20
  • 1Medical Oncology, Osp San Gerardo, 20900 - Monza/IT
  • 2Oncology, University of Trieste-Ospedale di Cattinara, 34149 - Trieste/IT
  • 3Oncology, Presidio Ospedaliero Ospedale Sant'Anna, 22100 - San Fermo della Battaglia/IT
  • 4Medical Oncology, Azienda Ospedaliera St. Croce e Carle, 12100 - Cuneo/IT
  • 5Medical Oncology, AOU S. Giovanni Battista - Molinette, 10126 - Torino/IT
  • 6Medical Oncology, AO San Martino IST, genova/IT
  • 7Radioterapia, Azienda Ospedaliera Universitaria Careggi, Florence/IT
  • 8Medical Oncology, P.O. Clinicizzato Ss. Annunziata Universita' Degli Studi, 66100 - Chieti/IT
  • 9Medical Oncology, Azienda Ospedaliera Universitaria S.Chiara, 56100 - Pisa/IT
  • 10Medical Oncology, AOU S. Giovanni Battista - Molinette, torino/IT
  • 11Medical Oncology, AO Cardarelli, Napoli/IT
  • 12Medical Oncology, IRCCS Fondazione Pascale, Napoli/IT
  • 13Medical Oncology, Azienda Ospedaliera St. Andrea, 00189 - Roma/IT
  • 14Medical Oncology, Ist Candiolo, Torino/IT
  • 15Medical Oncology, Ospedale Generale Provinciale Macerata, 62100 - Macerata/IT
  • 16Medical Oncology, Università degli studi di Napoli "Federico II"-Dipartimento di Medicina Clinica e Chirurgia – Oncologia, Napoli/IT
  • 17Medical Oncology, IRCCS AOU San Martino - IST-Istituto Nazionale per la Ricerca sul Cancro, 16132 - Genova/IT
  • 18Medical Oncology, Ospedale di Prato Sandro Pitigliani Med. Oncology Unit, 59100 - Prato/IT
  • 19Medical Oncology, Azienda Ospedaliera Arcispedale Santa Maria Nuova - IRCCS, 42100 - Reggio Emilia/IT
  • 20Medical Oncology, Ospedale Universitario Verona, 37129 - Verona/IT



ESO/ESMO develops consensus guidelines for MBC treatment every 2 years, potentially applicable worldwide. Aim of the present analysis is to verify the adherence to ABC recommendations for HER2-ve MBC in the context of the AMBRA study.


AMBRA is a longitudinal cohort study, aiming to describe the choice of first and subsequent lines of treatment in HER2-ve MBC pts receiving at least one Chemotherapy (CHT) (SABCS 2016, P5-15-07 & P5-14-09). For the present analysis, we selected 4 statements from the ABC1 & ABC2 Conferences, comparing them with the clinical choices of 1st-line therapy in all evaluable cases.


So far, 791 pts have been enrolled, of whom 586 (74.1%) have received CHT as 1st-line treatment. 479 pts (81.7%) had Luminal tumours at diagnosis. First-line CHT was monotherapy in 89 pts (25.2%), anthra-based CHT in 45 (7.7%) and platinum-based in 38 (6.5%), mainly TNBC (20/38, 52.6%). Selected recommendations and percentages of adherence are reported in Table.Table:

259P Adherence to ABC recommendations for HER2-ve pts

n/N (%of adherence)
1 - Anthracycline (A)- or Taxane (T)-based regimens, preferably as a single agent, would usually be considered as first-line CHT, in those pts who have not received these regimens as adjuvant treatmentA/T mono 59/ 270 (21.8%)160/270 (59.2%)
A/T poly 101/ 270 37.4%)
2 - In pts with taxane-naive and anthracycline-resistant MBC, taxane-based therapy, preferably as a single agent, would usually be considered as the treatment of choiceT mono 89/ 431 (20.6%)208/431 (48.2%)
T poly 119/ 431 (27.6%)
3 - Other options are Capecitabine and Vinorelbine135/586 (23.0%)
4 - If given in the adjuvant setting, a taxane can be re-used in the metastatic setting, particularly if there has been at least 1 year of disease-free survivalDFI > 12 months 74/79 (93.7%)79/151 (52.3%)


The adherence to clinical recommendations is very low, being only partially applied in all the clinical situations analyzed. Educational interventions are urgently needed and a confrontation with the clinical community is strongly recommended.

Clinical trial identification

Legal entity responsible for the study

Marina E. Cazzaniga


Celgene Intl.


All authors have declared no conflicts of interest.