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 treatment||A/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 choice||T mono 89/ 431 (20.6%)||208/431 (48.2%)|
|T poly 119/ 431 (27.6%)|
|3 - Other options are Capecitabine and Vinorelbine||135/586 (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 survival||DFI > 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
All authors have declared no conflicts of interest.