Thresholds for therapies: Highlights of the St Gallen international expert consensus on the primary therapy of early breast cancer 2009

Aron Goldhirsch, J. N. Ingle, R. D. Gelber, A. S. Coates, B. Thürlimann, H. J. Senn

Research output: Contribution to journalArticle

1081 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1319-1329
Number of pages11
JournalAnnals of Oncology
Volume20
Issue number8
DOIs
StatePublished - 2009

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Consensus
Breast Neoplasms
Estrogen Receptors
Therapeutics
Switzerland
Decision Making
Neoplasms

Keywords

  • Early breast cancer
  • St Gallen Consensus
  • Therapies

ASJC Scopus subject areas

  • Oncology
  • Hematology
  • Medicine(all)

Cite this

Thresholds for therapies : Highlights of the St Gallen international expert consensus on the primary therapy of early breast cancer 2009. / Goldhirsch, Aron; Ingle, J. N.; Gelber, R. D.; Coates, A. S.; Thürlimann, B.; Senn, H. J.

In: Annals of Oncology, Vol. 20, No. 8, 2009, p. 1319-1329.

Research output: Contribution to journalArticle

Goldhirsch, Aron ; Ingle, J. N. ; Gelber, R. D. ; Coates, A. S. ; Thürlimann, B. ; Senn, H. J. / Thresholds for therapies : Highlights of the St Gallen international expert consensus on the primary therapy of early breast cancer 2009. In: Annals of Oncology. 2009 ; Vol. 20, No. 8. pp. 1319-1329.
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