人类表皮生长因子受体2(HER2)-低乳腺癌最近已成为乳腺肿瘤的可靶向子集,基于新型抗HER2抗体-药物偶联物临床试验的证据。这种进化引发了几个生物学和临床问题,保证建立最佳治疗HER2低乳腺肿瘤患者的共识。在2022年至2023年之间,欧洲医学肿瘤学会(ESMO)举行了一项针对低HER2乳腺癌的虚拟共识建立过程。共识包括一个由来自9个不同国家的32名乳腺癌管理领先专家组成的多学科小组。达成共识的目的是就当前ESMO临床实践指南中未详细涵盖的主题发表声明。讨论的主要主题是(i)低HER2乳腺癌的生物学;(ii)低HER2乳腺癌的病理诊断;(iii)低HER2转移性乳腺癌的临床管理;(iv)低HER2乳腺癌的临床试验设计。专家小组分为四个工作组,以解决与上述四个主题之一有关的问题。提前对相关科学文献进行了回顾。工作组制定了共识声明,然后提交给整个小组进行进一步讨论和修改,然后再进行表决。本文介绍了已开发的陈述,包括专家小组讨论的结果,专家意见,以及支持每个陈述的证据摘要。
Human epidermal growth factor receptor 2 (HER2)-low breast cancer has recently emerged as a targetable subset of breast tumors, based on the evidence from clinical trials of novel anti-HER2 antibody-drug conjugates. This evolution has raised several biological and clinical questions, warranting the establishment of
consensus to optimally treat patients with HER2-low breast tumors. Between 2022 and 2023, the European Society for Medical Oncology (ESMO) held a virtual
consensus-building process focused on HER2-low breast cancer. The
consensus included a multidisciplinary panel of 32 leading experts in the management of breast cancer from nine different countries. The aim of the consensus was to develop statements on topics that are not covered in detail in the current ESMO Clinical Practice
Guideline. The main topics identified for discussion were (i) biology of HER2-low breast cancer; (ii) pathologic diagnosis of HER2-low breast cancer; (iii) clinical management of HER2-low metastatic breast cancer; and (iv) clinical trial design for HER2-low breast cancer. The expert panel was divided into four working groups to address questions relating to one of the four topics outlined above. A review of the relevant scientific literature was conducted in advance.
Consensus statements were developed by the working groups and then presented to the entire panel for further discussion and amendment before voting. This article presents the developed statements, including findings from the expert panel discussions, expert opinion, and a summary of evidence supporting each statement.