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

...eatmen...

...mmendations from 2024 Rapid Recommend...

...1.1The Expert Panel recommends multiple...

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


...1. Treatment Options According to Prio...


Recommendations from 2023 Rapid Recommendation U...

...atment selection, the Expert Panel re...

...eviously treated with ET and a CDK4/6 inhibitor...


...ions from 2022 Focused Guideline Update

...ndation 1.1Patients with locally recu...

...on 3.1Patients with metastatic HER2-negat...

...ation 3.2There is insufficient evidence to...

...endation 4.1There are insufficient d...

Recommendation 5.1Patients with locally recurrent...

...n 6.1Patients with metastatic cancer...

...dation 7.1Patients with metastatic cancer wh...

...mmendation 8.1Clinicians may test for N...

...commendation 9.1There are insufficient data to rec...

...ecommendation 10.1There are insuffi...

...ecommendation 11.1There are insufficient data to...


...ns Unchanged From 2015 Guidelin...

...presentation of metastasis from breast...

...ion for Tissue Biomarkers...

...atients who are already receiving syst...

...ations for Circulating Tumor Markers...

...atients already receiving systemic ther...

...onic antigen (CEA), cancer antigen (...

...de to ASCO Biomarker Testing in Metastatic...

...omarker Tests Recommended by the ASCO Expert...

...marker Tests Not Recommended by the ASCO E...


...-A-Glance Guide to ASCO Biomarker Testing in Metas...


...le 2. At-A-Glance Guide to ASCO Biomarker Tes...


...ves that cancer clinical trials are vital to in...