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Metastatic Breast Cancer, Version 1.2012

Featured Updates to the NCCN Guidelines

Robert W. Carlson, D. Craig Allred, Benjamin O. Anderson, Harold J. Burstein, Stephen B. Edge, William B. Farrar, Andres Forero, Sharon Hermes Giordano, Lori J. Goldstein, William J. Gradishar, Daniel F. Hayes, Clifford A. Hudis, Steven Jay Isakoff, Britt-Marie E. Ljung, David A. Mankoff, P. Kelly Marcom, Ingrid A. Mayer, Beryl McCormick, Lori J. Pierce, Elizabeth C. Reed, Mary Lou Smith, Hatem Soliman, George Somlo, Richard L. Theriault, John H. Ward, Antonio C. Wolff, Richard Zellars, Rashmi Kumar, and Dorothy A. Shead

postmenopausal women with hormone receptor–positive advanced breast cancer that had progressed or recurred during treatment with a nonsteroidal aromatase inhibitor randomized patients to exemestane with or without the mTOR inhibitor everolimus. 17 The results of

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Robert W. Carlson, Susan Moench, Arti Hurria, Lodovico Balducci, Harold J. Burstein, Lori J. Goldstein, William J. Gradishar, Kevin S. Hughes, Mohammad Jahanzeb, Stuart M. Lichtman, Lawrence B. Marks, Joan S. McClure, Beryl McCormick, Lisle M. Nabell, Lori J. Pierce, Mary Lou Smith, Neal S. Topham, Tiffany A. Traina, John H. Ward, and Eric P. Winer

aromatase inhibitors. 27 , 28 Life Expectancy Estimation of survival was identified by many task force participants as a key factor in making treatment decisions for older women with breast cancer. Data from the U.S. Centers for Disease Control and

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Crystal S. Denlinger, Jennifer A. Ligibel, Madhuri Are, K. Scott Baker, Wendy Demark-Wahnefried, Debra L. Friedman, Mindy Goldman, Lee Jones, Allison King, Grace H. Ku, Elizabeth Kvale, Terry S. Langbaum, Kristin Leonardi-Warren, Mary S. McCabe, Michelle Melisko, Jose G. Montoya, Kathi Mooney, Mary Ann Morgan, Javid J. Moslehi, Tracey O’Connor, Linda Overholser, Electra D. Paskett, Muhammad Raza, Karen L. Syrjala, Susan G. Urba, Mark T. Wakabayashi, Phyllis Zee, Nicole McMillian, and Deborah Freedman-Cass

breast surgery and 50% in those treated with lung surgery. 1 Arthralgias, characterized by joint pain and stiffness, occur in roughly half of women taking aromatase inhibitors as adjuvant therapy for breast cancer. 15 Pelvic pain often occurs after

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Christopher P. Chung, Carolyn Behrendt, Louise Wong, Sarah Flores, and Joanne E. Mortimer

of 0 to 5, with 0 being “not bothersome” and 5 being “extremely bothersome.” 8 Adjuvant endocrine trials of aromatase inhibitors compared with tamoxifen have not reported an increase in bladder symptoms. 9 , 10 The Mind-Body Study reported more

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Presenter: William J. Gradishar

, this is predominantly CDK4/6 inhibitors. First-line trials of 3 CDK4/6 inhibitors in combination with aromatase inhibitors have consistently demonstrated a significantly and clinically relevant increase in progression-free survival (PFS), with data

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Cindy Railton, Sasha Lupichuk, Jennifer McCormick, Lihong Zhong, Jenny Jaeeun Ko, Barbara Walley, Anil A. Joy, and Janine Giese-Davis

to aromatase inhibitors (AIs). Analysis To summarize demographic, chart review, pharmacy, and interview data, we used descriptive statistics, SAS 9.3, and 2-tailed tests. Using chi-square and Fisher exact tests, we compared PCP versus cancer

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Julia C. Shih and Anthony J. Olszanski

. 6 Within cancer care, the earliest reports of nonadherence rates were documented in breast cancer with endocrine therapies, ranging from 12% to 59% with tamoxifen and 9% to 50% with aromatase inhibitors. 7 In a systematic review by Greer et al, 1

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Therese B. Bevers

aromatase inhibitors (AIs) exemestane and anastrozole have shown even greater breast cancer risk reduction for women at increased risk of developing the disease. 5 , 6 However, the trials were small and these agents are not currently FDA-approved for this

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Scott Ramsey and Veena Shankaran

: 36 – 46 . 23 Sedjo RL Devine S . Predictors of non-adherence to aromatase inhibitors among commercially insured women with breast cancer . Breast Cancer Res Treat 2011 ; 125 : 191 – 200 . 24 Kelley RK Venook AP

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Azeez Farooki

with various cancer therapies, including aromatase inhibitor (AI) therapy in postmenopausal women and AI therapy and gonadotropin-releasing hormone (GnRH) agonists in pre-menopausal women with breast cancer, bone marrow transplantation in patients with