Biomarkers for Systemic Therapy in Metastatic Breast Cancer

Publication Date: March 13, 2024

Key Points

Key Points

This update expands the scope of the 2015 guideline to address topics that have emerged since its publication:
Testing for ESR1, PIK3CA, AKT1 and inactivation of PTEN somatic variants and germline BReast CAncer gene 1 (BRCA1), BReast CAncer gene 2 (BRCA2), and partner and localizer of BRCA2 (PALB2) pathogenic variants (mutations) to guide therapy.
Testing tumors for homologous recombination deficiency, expression of programmed cell death ligand-1 (PD-L1), deficient mismatch repair microsatellite instability (dMMR/MSI), tumor mutational burden (TMB), neurotrophic tyrosine receptor kinase (NTRK) gene fusions, and trophoblast cell-surface antigen 2 (TROP2) expression to determine eligibility for selected treatments.
The use of cell-free, circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) for monitoring treatment response.

Treatment

...atment...

...mmendations from 2024 Rapid Recommendation Upda...

...on 1.1The Expert Panel recommends multipl...

....2There are no comparative efficacy data fo...


...le 1. Treatment Options According to Prior...


...ns from 2023 Rapid Recommendation Update...

...ment selection, the Expert Panel recomm...

...nts previously treated with ET and a CDK4...


...ndations from 2022 Focused Guidelin...

...ommendation 1.1Patients with locally recurrent...

....1Patients with metastatic HER2-negative breast ca...

....2There is insufficient evidence to support a rec...

...ndation 4.1There are insufficient data at present...

...dation 5.1Patients with locally recurrent unres...

...6.1Patients with metastatic cancer who...

...dation 7.1Patients with metastatic cance...

...ecommendation 8.1Clinicians may test f...

...dation 9.1There are insufficient data to r...

...ndation 10.1There are insufficient...

...ation 11.1There are insufficient data to rec...


...ions Unchanged From 2015 Guideline...

...itial presentation of metastasis f...

...commendation for Tissue Biomarkers

...patients who are already receiving sys...

...ons for Circulating Tumor Mark...

...patients already receiving systemic therap...

...yonic antigen (CEA), cancer antigen (CA) 15...

...Glance Guide to ASCO Biomarker Testing in Metast...

...marker Tests Recommended by the ASCO Ex...

...ker Tests Not Recommended by the AS...


.... At-A-Glance Guide to ASCO Biomarker T...


...able 2. At-A-Glance Guide to ASCO Biomark...


...ASCO believes that cancer clinical...