@article{e0f0a762ef7d4375ac1d66cb27be7cb2,
title = "Thresholds for therapies: Highlights of the St Gallen international expert consensus on the primary therapy of early breast cancer 2009",
abstract = "The 11th St Gallen (Switzerland) expert consensus meeting on the primary treatment of early breast cancer in March 2009 maintained an emphasis on targeting adjuvant systemic therapies according to subgroups defined by predictive markers. Any positive level of estrogen receptor (ER) expression is considered sufficient to justify the use of endocrine adjuvant therapy in almost all patients. Overexpression or amplification of HER2 by standard criteria is an indication for anti-HER2 therapy for all but the very lowest risk invasive tumours. The corollary is that ER and HER2 must be reliably and accurately measured. Indications for cytotoxic adjuvant therapy were refined, acknowledging the role of risk factors with the caveat that risk per se is not a target. Proliferation markers, including those identified in multigene array analyses, were recognised as important in this regard. The threshold for indication of each systemic treatment modality thus depends on different criteria which have been separately listed to clarify the therapeutic decision-making algorithm.",
keywords = "Early breast cancer, St Gallen Consensus, Therapies",
author = "Aron Goldhirsch and Ingle, {J. N.} and Gelber, {R. D.} and Coates, {A. S.} and B. Th{\"u}rlimann and Senn, {H. J.}",
note = "Funding Information: Members of the Panel are listed below. All had a significant input to the discussion and manuscript. John Forbes and Stella Kyriakides were unable to attend the Panel session, but provided input for the planning of the meeting and reviewed and approved the manuscript. Matti Aapro, Clinique de Genolier, 1 Route du Muids, 1245 Genolier, Switzerland; Kathy S. Albain, Loyola University Medical Center, Cardinal Bernardin Cancer Center, 2160 S First Avenue, Room 109, Maywood, IL 60153, USA; Jonas Bergh, Department of Oncology, Karolinska Institute and University Hospital, 17176 Stockholm, Sweden; Harold Burstein, Department of Medical Oncology/Solid Tumor Oncology, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115, USA; Robert Carlson, Medical Oncology, Stanford University, 875 Blake Wilbur Drive, Stanford, CA 94305-5826, USA; Monica Castiglione-Gertsch, MHA ISPM/RGT University of Geneva, Boulevard de la Cluse 55, 1205 Geneva, Switzerland; Alan S. Coates, International Breast Cancer Study Group and University of Sydney, Sydney, 40 Cook Road, Centennial Park NSW 2021, Australia; Marco Colleoni, Research Unit Medical Senology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy; Alberto Costa, European School of Oncology, Via del Bollo 4, 20123 Milan, Italy; Jack Cuzick, Cancer Research, UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Queen Mary College, University of London, Charterhouse Square, London EC1M 6BQ, UK; Nancy Davidson, Director, University of Pittsburgh Cancer Institute, 5150 Centre Avenue, UPMC Cancer Pavilion, 5th Floor, Suite 500, Pittsburgh, PA 15232, USA; Angelo Di Leo, Sandro Pitigliani Medical Oncology Unit, Department of Oncology, Hospital of Prato, Piazza dell{\textquoteright}Ospedale, 59100 Prato, Italy; John F. Forbes, ANZ Breast Cancer Trials Group, University of Newcastle, Locked Bag 7, Hunter Region Mail Centre, NSW 2310, Newcastle, Australia (Absent); Richard D. Gelber, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115, USA; John H. Glick, University of Pennsylvania, Abramson Cancer Center, 16 Penn Tower, 3400 Spruce Street, Philadelphia, PA 19104-4283, USA; Joseph Gligorov, APHP Tenon, Cancer Est, 4 Rue de la Chine, 75020 Paris, France; Michael Gnant, Department of Surgery, Medical University of Vienna, W{\"a}hringer G{\"u}rtel 18-20, 1090 Wien, Austria; Aron Goldhirsch, International Breast Cancer Study Group, Oncology Institute of Southern Switzerland, 6500 Bellinzona, Switzerland and European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy (Chairman); Paul E. Goss, Director, Breast Cancer Research, MGH Cancer Center, 55 Fruit Street, Boston, MA 02114, USA; Jay Harris, Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women{\textquoteright}s Hospital, Room 1622, 44 Binney Street, Boston, MA 02115, USA; James N. Ingle, Mayo Clinic Cancer Center, Breast Cancer Research Program, 200 First Street, S.W., Rochester, MN 55905, USA (Chairman); Jacek Jassem, Department of Oncology & Radiotherapy, Medical University of Gdansk, Debinki Street 7, 80-211 Gdansk, Poland; Per Karlsson, Department of Oncology, Sahlgrenska University Hospital, 41345 G{\"o}teborg, Sweden; Manfred Kaufmann, Director, Department Gynecology, Obstetrics and Breast Unit, J.W. Goethe University Hospital, Theodor Stern Kai 7, 60596 Frankfurt a. M., Germany; Stella Kyriakides, Europa Donna Cyprus, 28 Prodromou Street, 2406 Nicosia, Cyprus (Absent); Louis Mauriac, Institute Bergoni{\'e}, Regional Cancer Center, 229 Cours d{\textquoteright}Argonne, 33076 Bordeaux, France; Gunter von Minckwitz, GBG Forschungs GmbH, Schleussnerstrasse 42, 63263 Neu Isenburg, Germany; Monica Morrow, Breast Surgery Service, Anne Burnett Windfohr Chair of Clinical Oncology, Memorial Sloan-Kettering Cancer Center, Department of Surgery, 1275 York Avenue MRI 1026, New York, NY 10065, USA; Henning T. Mouridsen, Department of Oncology, Finsen Center 5074, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark; Moise Namer, Head, Medical Oncology, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice Cedex 2, France; Larry Norton, Director of Breast Cancer Program, Memorial Sloan-Kettering Cancer Center, Room H 901, 205 East 64th Street, Concourse Level, New York, NY 10021-6007, USA; Soonmyung Paik, National Surgical Adjuvant Breast and Bowel Project, 4929 Bayard Street, Pittsburgh, PA 15213, USA; Martine J. Piccart-Gebhart, Internal Medicine, Oncology, Institut Jules Bordet, Rue H{\'e}ger-Bordet 1, 1000 Brussels, Belgium; Kurt Possinger, Universit{\"a}tsklinikum Charit{\'e} Campus Mitte, Centrum 14, M.S. Onkologie/ H{\"a}matologie, Charit{\'e}platz 1, 10117 Berlin, Germany; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Ontario Clinical Oncology Group, 2075 Bayview Avenue, Toronto, Ontario M4N 1H6, Canada; Emiel J.T. Rutgers, The Netherlands Cancer Institute, Department of Surgery, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands; Vladimir F. Semiglazov, N.N. Petrov Research Institute of Oncology, 68 Leningradskaya Street, Pesochny-2, 197758 St. Petersburg, Russia; Ian Smith, Department of Medicine, Royal Marsden Hospital and Institute of Cancer Research, Fulham Road, London, SW3 6JJ, UK; Beat Th{\"u}rlimann, Breast Center, Kantonsspital St Gallen, 9007 St Gallen, Switzerland; Giuseppe Viale, Department of Pathology, European Institute of Oncology and University of Milan, Via Ripamonti 435, 20141 Milan, Italy; Toru Watanabe, Department of Medicine, Hamamatsu Oncology Center, 3-6-13 Chuo Naka-Ku, 430-0929 Hamamatsu, Japan; Eric P. Winer, Breast Oncology Center, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA, 02115, USA; William C. Wood, Department of Surgery, Suite B 206, Emory University Hospital, 1364 Clifton Road, Atlanta, GA 30322, USA.",
year = "2009",
doi = "10.1093/annonc/mdp322",
language = "English (US)",
volume = "20",
pages = "1319--1329",
journal = "Annals of Oncology",
issn = "0923-7534",
publisher = "Oxford University Press",
number = "8",
}