What are the ASCO guidelines on adjuvant therapy for breast cancer?

Updated: May 21, 2019
  • Author: Erin V Newton, MD; Chief Editor: Neetu Radhakrishnan, MD  more...
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Answer

Answer

Guideline recommendations included the following:

  • For patients at high risk of recurrence, treatment with an anthracycline and a taxane is preferred
  • For patients not felt to be candidates for anthracyclines, docetaxel/cyclophosphamide or cyclophosphamide/methotrexate/5-fluorouracil are acceptable alternative regimens 
  • On the basis of recent negative trials, gemcitabine and capecitabine are not recommended in the adjuvant setttings
  • For patients with node-negative Her2Neu-positive cancer (defined as 3+ on immunohistochemistry a ratio of ≥ 2.0 on fluorescent in situ hybridization [FISH] testing, or a Her2 copy number ≥ 6) with tumors > 1 cm, trastuzumab should be offered for 12 months. It can also be considered in patients with tumors ≤ 1 cm. When given in this setting, trastuzumab should be given concurrently with non-anthracycline chemotherapy.

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