ecancermedicalscience

Conference Report

Highlights from the 14th St Gallen International Breast Cancer Conference 2015 in Vienna: Dealing with classification, prognostication, and prediction refinement to personalize the treatment of patients with early breast cancer

31 Mar 2015
Angela Esposito, Carmen Criscitiello, Giuseppe Curigliano

The refinement of the classification, the risk of relapse and the prediction of response to multidisciplinary treatment for early breast cancer has been the major theme of the 14th St Gallen International Breast Cancer Consensus Conference 2015. The meeting, held in Vienna, assembled 3500–4000 participants from 134 countries worldwide. It culminated, on the final day, with the International Consensus Session, delivered by 40–50 of the world’s most experienced opinion leaders in the field of breast cancer treatment. The panelists addressed the “semantic” classification of breast cancer subtypes by pathology-based biomarkers (e.g. estrogen receptor, progesterone receptor and HER2) vs genomic classifiers. They also refined the biomarker prognostication dissecting the impact of the various gene signatures and pathologic variables in predicting the outcome of patients with early breast cancer in terms of early and late relapse. Finally they addressed the challenges stemming from the intra- and inter-observer variability in the assessment of pathologic variables and the role of gene signatures for the prediction of response to specific therapeutic approach such as endocrine therapy and chemotherapy and for personalizing local treatment of patients with early breast cancer. The vast majority of the questions asked during the  onsensus were about controversial issues. The opinion of the panel members has been used to implement guidance for treatment choice. This is the unique feature of the St. Gallen Consensus, ensuring that the resulting recommendations will take due cognizance of the variable resource limitations in different countries. Information derived from evidence based medicine and large meta-analyses is of obvious and enormous value. The weakness of this approach is that it gives particular weight to older trials (which have accumulated more event endpoints) and is frequently unable to collect sufficient detail on the patients and tumors in the trials to allow assessment of whether the treatments which are better on average offer equal value to all currently definable patient subgroups. What St Gallen can provide is clinically useful updated breast cancer treatment consensus for the majority of patients treated outside of clinical trials (>90%) in most countries.

Related Articles

Julia Downing, Eve Namisango, Stephen Connor, Patricia Batanda, Lisa Christine Irumba, Berna Basemera, Alfred Jatho, Sylvia Nakami, Harriet Nalubega, Antonia Kamate, Dianah Basirika, Joyce Zalwango, Mable Nammudu, Wedzerai Chiyoka, Francis Kayondo, David Byaruhanga, Eugene Rusanganwa, Helena Davis, Stephen Watiti, Babe Gaolebale, Lacey N Ahern, Lydia Thomas, Emmanuel Luyirika
Deevyashali Parekh, Vijay M Patil, Kavita Nawale, Vanita Noronha, Nandini Menon, Sucheta More, Supriya Goud, Srushti Jain, Vijayalakshmi Mathrudev, Zoya Peelay, Sachin Dhumal, Shweta Jogdhankar, Kumar Prabhash
Ana Teresa Vilares, Riccardo Ciabattoni, Teresa Margarida Cunha, Ana Félix
María Fernanda Toro-Wills, Angelina Álvarez-Londoño, Abraham Hernández-Blanquisett, Fernando Salas Marquez, María Cristina Martínez-Ávila
Maya M Hicks, Kenneth Chanda, Mulindi Mwanahamuntu, Monica B Jones, Anissa R Mattison, Krista S Pfaendler, Leeya F Pinder, Groesbeck P Parham, Michael L Hicks