Year: 2026
Type: article
Abstract: After every ABC Conference, we report an interview with experts from the conference – oncologists’ and patients’ advocates. At ABC8, 1,200 participants (oncologists, nurses, patients advocacy) attended on-site or online coming from 84 countries.The ABC8 Consensus Conference (Lisbon, November 6th to 8th 2025) is the major international conference fully dedicated to advanced/metastatic breast cancer (ABC). Fatima Cardoso, Chair of the conference, in her opening, said the following:The conference is organized by the ABC Global Alliance, an independent multi-stakeholder organization to improve and extend lifetime for patients with ABC worldwide, with more than 280 members in over 100 countries worldwide and a clear vision: collaboration and sharing.At ABC 8, the 2015–2025 Global Decade Report was launched at the conference and the new 2025–2035 (Fig. 1) was also launched. The new 10 goals for the next decade are set.With 45 speakers/panelists, the conference was chaired by F. Cardosos and R. Kaur, with the guideline session again moderated by E.P. Winer. The 2025 consensus results will be published in Breast Care from a German point of view and later in its full version in Annals of Oncology from the panelists. More information is available at: https://www.abc.lisbon.org and https://www.abcglobalalliance.orgHere, we give personal insights into participants’ feedback to this year’s ABC8 from different points of views. All experts were in-person speakers, panelists, and/or part of this year’s scientific committee and/or ABC Global Alliance.Rachel Wuerstlein: What is your personal motivation in engaging in ABC and the ABC Consensus Conference?Eva Schumacher-Wulf: The ABC is a truly patient-centric organization focusing on advanced BC only. This unique approach motivates me to get involved.Volkmar Mueller: Patient involvement and international exchange are becoming increasingly important as we experience an improvement in therapeutic options for metastatic breast cancer. There are many aspects where patient involvement has become essential, for example, weighing between efficacy and side effects of therapeutic options. Also, the international view on therapy in different regions of the world is very important for me. Like in the previous ABC conferences, I found this exchange extremely helpful and motivating.Orit Kaidar-Person: This is the first time I am participating in the ABC as I was selected by ESTRO (European Society for Radiotherapy and Oncology) to represent ESTRO breast faculty. In addition to the ABC guidelines, which are often quoted in our clinical discussions, I was eager to participate in the meeting as I heard a lot about the ABC meeting from colleagues, who indicated that it “a special meeting” noting that the discussions are not only evidenced based with leading experts, but there is a lot of input from patients advocates and a global view of what is available in different countries. It gives a different view on one’s own practice.Renate Haidinger: The needs of patients with advanced or metastatic breast cancer differs widely in many aspects. The exchange with patients, patient advocates and physicians from all over the world is permanent learning for me, even after 24 years of counseling patients and providing information. Guidelines, especially for these patients while treatments options emerge, are extremely important.Joana Mourato Ribeiro: A conference held in my favorite city, bringing together colleagues with whom I love sharing meaningful moments – in addition to outstanding science.Shani Paluch-Shimon: It is an opportunity to have a global impact on the lives of many women. The focus on advanced breast cancer is unique and the forum where a stage is given for the voice of the patient in such a significant way is one of a kind.Rachel Wuerstlein: Please share your most important message or panel result from ABC8 with us, and what will you change in your daily practice “on Monday” after ABC 8?Eva Schumacher-Wulf: One of the most controversial discussions concerned whether screening patients with asymptomatic central nervous system (CNS) metastases should be the standard of care. This is a difficult yet important question that requires our full attention. Therefore, I will continue to advocate for clinical trials in this field.Volkmar Mueller: Many of the discussions and inputs will influence my daily work: just as an example, I was participating in a session on oral therapies in advanced breast cancer. From my perspective, I gave a presentation strongly arguing for oral therapies. The patient aspect was a little bit more skeptic, highlighting challenges for patients taken already medications other than for cancer therapies with many tablets and potential interactions. This left me with a more differentiated approach.Orit Kaidar-Person: The talk by Anne May, about exercise and body composition, will have significant impact on my practice. We do recommend patients return to physical activity as part of their rehabilitation, and the physiology of moderate activity makes sense and is supported in studies mainly as a risk-reducing approach or part of treatment in chronic disease. Cancer is often regarded as “non-modifiable disease.” Anne’s talk reassured us that we should not only recommend those healthy habits but have them “supervised” as part of treatment. Health habits, including supervised physical activity – should be a priority for our patients.Renate Haidinger: We need better tailoring of treatments, especially as dosage is concerned but also a better guidance for patients for different oral therapies at the same time.Joana Mourato Ribeiro: For HER2-positive breast cancer, I may consider screening for CNS metastases at diagnosis in patients with a high tumor burden.For TNBC, the choice of first-line ADCs depends on patient preference and a shared decision-making process between patient and physician.For luminal breast cancer, multigene panels have now entered routine practice and will remain an integral part of ABC management; however, it is still too early to rely on the concept of molecular progression (as opposed to radiologic progression), and finally, remember that HER2 mutations can be actionable – so don’t forget to look for them in the molecular report.Shani Paluch-Shimon: One of the important messages from the Global Decade Report is that our patients are not receiving adequate multidisciplinary care and are not being discussed enough in MDT meetings – and while this is a greater problem in resource-low countries – it’s a problem everywhere – and that’s something I’ll be trying to improve locally. The other important issue that was raised repeatedly by the panel was the concern about the number of clinical trials being performed with inappropriate control arms, not enough use of cross-over and not enough thought about incorporating treatment arms that switch the patients to less toxic maintenance regimens once optimal disease control has been reached.Rachel Wuerstlein: Please comment on the discussion ABC8 about the option of cure in ABC.Eva Schumacher-Wulf: Interesting question. I think we are on the right track to 1 day talking about cure. However, we need more evidence to understand in which cases therapy could be stopped.Volkmar Mueller: I was chairing this session and was really impressed by the contributions. There are several aspects for patients on long-term remission for MBC, and we all struggle a little bit about the wording “cure.” It is a fact that, for some patients with long-term remission, MBC is a chronic disease that might even allow to omit and stop therapy. The discussion about when to stop therapy or to deescalate was really interesting and brought in many different views between healthcare professionals and patients.Orit Kaidar-Person: A lot has changed in cancer therapy and survivorship in the past years. ABC in some patients becomes a “long-standing disease,” in which patients live for years, either with maintenance treatment or without any therapy. Our society needs to make proper adjustments and provide these patients with the support they need per individual needs including acknowledging that they can be active and productive members of the community. The ABC meeting is a good example to show how much work is actively done by these patients to support their peers and improve care worldwide. They are setting an example for us.Renate Haidinger: In general, MBC is still not curable, and it is not helpful and misleading for me just as the term chronic. As long as patients die of their metastatic disease, I would not use both of them.Shani Paluch-Shimon: We each have a handful of patients with ABC who we know are cured. The question is how we determine who is “cured” and when will these women be able to stop maintenance therapies. The most significant step forward for potential cure has unquestionably been anti-HER2 therapies.Rachel Wuerstlein: What is your key message from patient’s advocacy and or the ABC Global Alliance Decade Report 2015–2025?Of note: There was a 100% vote for the ABC Global Charter 2025-2035 (Fig. 1).Eva Schumacher-Wulf: Patients need access to new treatments! This is the only way to increase survivals rates.Volkmar Mueller: Many of the goals were very ambitious, but it is important to see that huge progress has been made in many fields, and this will encourage us to continue the work for the next decade.Orit Kaidar-Person: The ABC GA decade report is an impressive summary that provides scientific data and summarizes pivotal trials but also qualitative information from surveys of health practitioners and patients to address survival disparities across geographies, ethnicities, and socioeconomic groups. It provides an honest overview, expressing the gaps and calls to improve outcomes by expanding access to somewhat basic services for diagnostics and treatments to the top of the edge innovative treatments and research. In this spirit, the ABC guidelines aim to provide guidance for best practice but with the same breath call to reduce disparity in care, giving a realistic view of cost-effectiveness. As for the main key message I took with me from patient’s advocacy was that this is not only a “shared decision,” but they are “our partners” in all aspects.Renate Haidinger: I was on the Steering Committee for this report, and we definitely made progress, but there is still much room for improvements. Let's see how far we get with our charter from 2025 to 2035.Joana Mourato Ribeiro: My key message is that patient advocacy and the ABC Global Alliance have fundamentally reshaped the way we think about metastatic breast cancer. They have pushed the global community to recognize ABC as a distinct disease with unique needs, to prioritize quality of life, and to fight for equity of access to treatments and clinical trials. The Decade Report clearly shows that while important progress has been made, major disparities persist – and addressing these inequalities remain a central mission for all of us.Shani Paluch-Shimon: That advocating and setting goals makes a difference and translates to real changes – the global decade report is a remarkable testament to that. The report does, however, also highlight that there is still much to be done and that we must broaden the global impact, so improvements reach all women.Rachel Wuerstlein: Which panel vote did strike you most and why?Eva Schumacher-Wulf: The vote about the use of T-DXd in HER2 ultralow tumors. We all know that HER2 testing is not very reliable. Patients with even “a bit” HER2 should be given the chance to be treated with T-DXd – where available.Volkmar Mueller: As a panel member I was not completely surprised by any of the votings, difficult to say for me.Orit Kaidar-Person: I do not think anything struck me as it felt like attending a “high” level multidisciplinary meeting. All was evidence-based, and I enjoyed hearing the discussions, and the different experts’ views and patients’ views on some of the topics we voted on.Renate Haidinger: None especially. It is always a challenge to overcome the vast differences in access to treatments and the question if the guidelines should be somehow adapted to it.Joana Mourato Ribeiro: Brain imaging. The discussion was particularly rich – the exchanges, the reasoning, and even the evolution of the panel’s vote. I felt the final recommendation was a good compromise between the limited data we currently have and the scientific rationale and clinical implications of performing screening. It also made me reflect on the practice at my own institution and whether we will, or will not, change our approach.Shani Paluch-Shimon: The shift in vote about performing brain imaging in asymptomatic patients. While the statement is carefully qualified with clear caveats – this represents the significant progress that has been made treating CNS metastases in HER2+ ABC.Rachel Wuerstlein: There were controversial discussions in the panel on use of ADCs in the early lines in MBC. Please comment.Eva Schumacher-Wulf: I think it is important to have these discussions. I would not really discuss in the treatment of mTNBC with ADCs but, for sure, the treatment of HER2-positive mBC because there are less toxic treatments that sometimes work for years, especially in de novo mBC. The use of ADC first line should not be standard of care for all patients. Furthermore, we need de-escalation strategies after the use of ADC, when patients are stable.Volkmar Mueller: These discussions reflected the uncertainties about sequencing and also about the magnitude of benefit to use ADCs as first-line treatment if there is also an option to use them sequentially as second line. We need a better understanding which patients are in need of first-line treatment given the higher cost on toxicity of ADCs.Orit Kaidar-Person: In my view, it is natural to have controversies in the sequencing and use of ADC, based on the trials design and data out there. Especially as each treatment line has a different toxicity profile. This concept was nicely demonstrated by Bishal Gyawali’s presentation about end points in breast cancer trials, and what matters for patients.Renate Haidinger: As we do not have enough data, it is always a question what the best sequencing might be and how to preserve a good QoL for the Mourato Ribeiro: ADCs are treatment strategies for our patients increasingly across all by their However, the toxicity is also and one of the major challenges is how to treatment The challenges clearly between In the HER2-positive the focus is on patients who may be and on treatment In breast cancer, we need more active first-line ADCs provide survival very In the the optimal of these the patient’s treatment – at a time when more therapy – are becoming available – also represents a major Paluch-Shimon: of the ADCs have remarkable but toxicity is significant and being on these therapies for can be very difficult for patients. we will need to carefully who needs the ADCs early and that would allow and to a maintenance Wuerstlein: all the improvement in brain and should brain imaging be performed in asymptomatic patients with Schumacher-Wulf: especially HER2+ and mBC. It should at be to Mueller: My was that the of imaging into as was not However, the routine use of as would result challenges and potential to patients with early treatment. The in my was that it should be with in cases where therapeutic might from the diagnosis of brain and/or In these therapy should be discussed in a multidisciplinary Kaidar-Person: This is a question for the breast cancer community. In some of ABC I would say The key points of what is the potential and of this approach – for breast cancer patients were discussed for a about that question. In general, treatment of CNS disease has we can therapy – but we need understanding of the treatment approach not to our patients with too Haidinger: I definitely think brain imaging should be at the time of diagnosis of MBC. the and are the patient can make an Mourato Ribeiro: This I the key message from the panel – with which I – is for or HER2-positive especially if CNS involvement in an asymptomatic patient would influence treatment This of always be by a multidisciplinary discussion of the and therapeutic and patient shared Paluch-Shimon: I think it should be in asymptomatic patients with HER2+ if the of CNS disease will change the choice of Wuerstlein: supervised exercise should be into ABC care was a 100% this to your real world setting in your and or your Schumacher-Wulf: and We have in some however, there is still room for Mueller: I was very with this However, like all I know we have for these especially for MBC patients. There needs more differentiated online and that can support patients at Kaidar-Person: As I indicated this was an impressive presentation and my views and At this our is with and in the so I do not think we can this into daily practice. However, I do think this will encourage health maintenance that are already in the healthy community in such – and give them a and motivation to also in ABC patients. These patients with also from their health system – it might be to This recommendation is important – to encourage care. we do for the quality of and of our patients will to society – as they are an integral part of Haidinger: In general, it’s helpful for ABC patients to and exercise as long as it is not to the and there are patients that exercise for different We need to have some guidance for them as Mourato Ribeiro: the is there is still a lot of work to be Paluch-Shimon: supervised should be into ABC care was a 100% this to your real world setting in your and or your I have a who has a survivorship for our patients with – and we discussed that our for would be that a for patients with We are that we have a leading at one of our that us to such Wuerstlein: The panel voted with as an information do you see the most important of in Schumacher-Wulf: At the I see the of to however, it only makes sense when by could input in is not enough for treatment Mueller: should patients to understand their therapeutic options which we are often not able to to different not only time I think that is a and it would be optimal if we could that are reliable. There is a high need for support for in this also patients.Orit Kaidar-Person: I think is an important I am in the to a that shared decision-making by and the outcomes of the breast cancer treatment in early breast cancer. It is work to a is important – in and providing by of health practitioners – to with patients and their I am concerned of the potential and challenges and Therefore, I think should be supervised for Haidinger: is a good support for any of imaging and has still much to Mourato Ribeiro: In my view, many can be One where I would particularly like to see is the use of as a to and multidisciplinary this could be extremely for patients for clinical trials, to care, clinical and the of and molecular Paluch-Shimon: I think forward it will have a major impact in diagnostics and and data to and treatment in a world where the of and of data is so Wuerstlein: From to ABC in what will change in the in the treatment of patients with what will be our challenges in ABC in the next Schumacher-Wulf: One of the challenges will be the number of CNS We need more we need de-escalation strategies for long-term Mueller: the huge progress we have made over the years, not only with so many new therapeutic options but also with better patients into many aspects of therapy like design and guideline that they will be able to in this I am to be able to work in such a time with so many Kaidar-Person: I was impressed by the and honest presentation of about sequencing including and tumor I we will have more data about – to treatment than us.Renate Haidinger: and new will show Our challenge is to for look at the of data and where the patients from in the and because of different and challenge is how to make the for far more patients. At the ABC conference, as at all the experience and the experience of patient advocates is really This makes a huge different to all other breast cancer who just to patients and patient Mourato Ribeiro: We will have more data on how to ABC while into its implications and as a treatment I also that we will better understand – and have more options and evidence for – patients who after I that the new ADCs and will change the of our patients with metastatic breast cancer – clearly one of the of Paluch-Shimon: One of the challenges in ABC – is that all the new reach While we discuss how will we between the different ADCs – there are still countries that don’t have I think optimal sequencing of treatments is a huge challenge and out how to give optimal treatments that may be toxic and to more maintenance regimens will be very Wuerstlein: I to all the for their ABC will from November to in was supported by Oncology and was a member of the at the time of from and from and support from and and from and was a member of the at the time of and have of to Mourato personal support from the of and for and also support from the of and for – and for and – and support from from and and from and from from and and from was a member of the at the time of and of and Breast Cancer of of and Health of Breast Cancer Breast Cancer Mourato Breast Oncology in of
Source: Breast Care
DOI: 10.1159/000550030
Language: English
Subfield: Cancer Research
Domain: Life Sciences
Open Access status: bronze
OpenAlex ID: W7125963060
FWCI:
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