Guidance for Canadian Breast Cancer Practice: National Consensus Recommendations for the Systemic Treatment of Patients with HR+/HER2− Early Breast Cancer 2025
Year: 2026
Type: article
Abstract: Hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2-) early breast cancer (EBC) is the most common breast cancer subtype and encompasses a biologically heterogeneous group of tumours. Endocrine therapy (ET) remains the cornerstone of treatment, but decisions regarding chemotherapy, cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors, and bone-modifying agents must be tailored to tumour biology, clinical stage, and menopausal status. REAL Canadian Breast Cancer Alliance (REAL Alliance), a pan-Canadian group of breast cancer specialists, convened to develop national clinical consensus recommendations for the systemic management of HR+/HER2- EBC. Using a structured consensus process, 28 recommendations were endorsed, spanning neoadjuvant and adjuvant systemic therapy, surgical considerations, and use of bisphosphonates. Key recommendations include the selective use of neoadjuvant chemotherapy for high-risk or locally advanced disease; genomic testing to guide chemotherapy decisions, particularly in postmenopausal patients; ET as the foundation of adjuvant therapy with intensification using CDK4/6 inhibitors in higher-risk patients; and adjuvant bisphosphonates in postmenopausal women to reduce recurrence and improve survival. These consensus recommendations provide practical, evidence-based guidance to support individualized, patient-centred management of HR+/HER2- EBC in the Canadian context.
Source: Current Oncology
Authors: Sandeep Sehdev, Anil Abraham Joy, Jean-François Boileau, Nathaniel Bouganim, Christine Brezden-Masley, Jeffrey Q. Cao, David W. Cescon, Stephen Chia, Scott Edwards, Karen A. Gelmon, Katarzyna J. Jerzak, Aalok Kumar, Kara Laing, Nathalie LeVasseur, Christine Simmons, Marc Webster, Mita Manna, on behalf of Patient Advocacy, Breast Cancer Canada
Institutions: Ottawa Hospital, University of Alberta, Cross Cancer Institute, Jewish General Hospital, McGill University, McGill University Health Centre, Mount Sinai Hospital, University of Toronto, University of Calgary, Arthur J.E. Child Comprehensive Cancer Centre, Princess Margaret Cancer Centre, University of British Columbia, Memorial University of Newfoundland, Dr. H. Bliss Murphy Cancer Centre, Sunnybrook Health Science Centre, Odette Cancer Centre, University of Saskatchewan, Saskatoon Cancer Centre
Language: English
Subfield: Cancer Research
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $2,654
OpenAlex ID: W7128677125