Patients with HR-positive MBC with disease progression on an endocrine agent may be offered treatment with either endocrine therapy with or without targeted therapy or single-agent chemotherapy. Patients with HR-positive human epidermal growth factor receptor 2-negative MBC for whom chemotherapy is being considered should be offered single-agent chemotherapy rather than combination chemotherapy, although combination regimens may be offered for highly symptomatic or life-threatening disease. Patients with triple-negative MBC with germline BRCA mutations previously treated with chemotherapy may be offered a poly (ADP-ribose) polymerase inhibitor rather than chemotherapy. Patients with triple-negative MBC who have received at least two prior therapies for MBC should be offered treatment with sacituzumab govitecan. Patients with triple-negative, programmed cell death ligand-1-negative MBC should be offered single-agent chemotherapy rather than combination chemotherapy as first-line treatment, although combination regimens may be offered for life-threatening disease. Patients with triple-negative, programmed cell death ligand-1-positive MBC may be offered the addition of immune checkpoint inhibitor to chemotherapy as first-line therapy. The Expert Panel reviewed abstracts from the literature review and retained 14 articles. This guideline updates recommendations of the ASCO guideline on chemotherapy and targeted therapy for patients with human epidermal growth factor receptor 2-negative metastatic breast cancer (MBC) that is either endocrine-pretreated or hormone receptor (HR)-negative.Īn Expert Panel conducted a targeted systematic literature review guided by a signals approach to identify new, potentially practice-changing data that might translate into revised guideline recommendations. 21 Patient Representative, New York, NY.19 Virginia Oncology Associates, Norfolk, VA.17 Bon Secours St Francis, Midlothian, VA.16 Seattle Cancer Care Alliance and University of Washington, Seattle, WA.15 University of Vermont Health Network, Burlington, VT.13 UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC.10 Royal Marsden Hospital, London, United Kingdom.9 University of Minnesota, Minneapolis and Saint Paul, MN.8 MD Anderson Cancer Center, Houston, TX.7 University of Washington, Seattle, WA.5 Hospital of Prato, Istituto Toscano Tumori, Prato, Italy.4 Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA.3 Beth Israel Deaconess Medical Center, Boston, MA.2 American Society of Clinical Oncology, Alexandria, VA.

1 Massachusetts General Hospital, Boston, MA.

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