Chemotherapy and targeted therapy for human epidermal growth factor receptor 2–negative metastatic breast cancer that is either endocrine-pretreated or hormone receptor–negative: ASCO guideline rapid recommendation update

Chemotherapy and targeted therapy for human epidermal growth factor receptor 2–negative metastatic breast cancer that is either endocrine-pretreated or hormone receptor–negative: American Society of Clinical Oncology (ASCO) guideline rapid recommendation update

ASCO Rapid Recommendations Updates highlight revisions to select ASCO guideline recommendations as a response to the emergence of new and practice-changing data. The rapid updates are supported by an evidence review and follow the guideline development processes outlined in the ASCO Guideline Methodology Manual. The goal of these articles is to disseminate updated recommendations, in a timely manner, to better inform health practitioners and the public on the best available cancer care options.

In 2021, ASCO published a guideline on chemotherapy and targeted therapy for patients with human epidermal growth factor receptor 2 (HER2)–negative metastatic breast cancer that is either endocrine-pretreated or hormone receptor–negative. The DESTINY-Breast04 was a phase III, two-group, open-label, randomized multicenter trial that compared trastuzumab deruxtecan with the treatment of physician's choice (TPC, limited to capecitabine, eribulin, gemcitabine, paclitaxel, or nab-paclitaxel), in patients with metastatic HER2-low breast cancer (defined as HER2 immunohistochemistry [IHC] 1+ or 2+ and in situ hybridization [ISH]–negative) who had been previously treated with one or two lines of chemotherapy in the metastatic setting. Of note, patients with metastatic hormone receptor–positive metastatic breast cancer were required to have endocrine-refractory disease. The DESTINY-Breast04 results provided a strong signal indicating the need to update the 2021 guideline recommendations.


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