Check for updatesChemotherapy and Targeted Therapy forEndocrine-Pretreated or Hormone Receptor-Negative Metastatic Breast Cancer:ASCOGuideline Rapid Recommendation UpdateBeverly Moy,MD,MPH;R.Bryan Rumble,MSc2;and Lisa A.Carey,MD,ScM3;for the Chemotherapy and Targeted Therapy forEndocrine-Pretreated or Hormone Receptor-Negative Metastatic Breast Cancer Expert Panel三ASCO Rapid Recommendations Updates highlight revisions to select ASCO guideline recommendations as aresponse to the emergence ofnewand practice-changing data.The rapid updates are supported by an evidence■review and follow the guideline development processes outlined in the ASCO Guideline Methodology Manual.The goal of these articles is to disseminate updated recommendations,in a timely manner,to better informhealth practitioners and the public on the best available cancer care optionsnBACKGROUNDpublished in the Journal of Clinical Oncology.After aIn 2021,ASCO published a guideline on chemo-median follow-up of 10.2 months,the primary end pointtherapy and targeted therapy for patients with humanwas met with a 34%reduction in risk of progression orepidermal growth factor receptor 2(HER2)-negativedeath (hazard ratio [HR],0.66;95%CI,0.53 to 0.83;metastatic breast cancer that is either endocrine-P=.0003).The median PFS was 5.5 months (95%Cl,pretreated or hormone receptor-negative.1 That4.2 to 7.0)with SG and 4.0 months (95%Cl.3.1 to 4.4)guideline was updated in August 2022 to incorporatewith TPC.At 6 months,the PFS was 46%(95%Cl.39 tothe results of the DESTINY-Breast04 trial.2 The re-53)versus 30%(95%Cl,24to 37),and at 12 months,itsults of the TROPiCS-023 trial,published on Octoberwas 21%(95%Cl,15 to 28)versus 7%(95%Cl,3 to10,2022,provided another signal to update.14).At that time,median overall survival was not yetmature (HR,0.84;P=.14).Key grade =3 treatment-related adverse events with SG were diarrhea (5%)andMETHODSneutropenic complications including febrile neu-A targeted electronic literature search was conducted totropenia(4%)and neutropenic colitis (2%).ASSOCIATEDidentify any additional phase lll randomized controlledCONTENTtrials of treatment options in this patient population.NoAt the planned second interim analysis after a medianfollow-up of 12.5 months,SG had a statistically sig-The companion toadditional randomized controlled trials were identified.The original guideline Expert Panel was reconvened tonificant improvement in overall survival compared withthis article waspublished in thereview new evidence from TROPiCS-023 and to reviewTP℃(HR.0.79:95%Cl.0.65to0.96:P=020).4TheDecember 10,2021and approve the revised recommendation.median overall survival was 14.4 versus 11.2 monthsissue of Joumal ofin patients treated with SG and TPC,respectively.Clinical Oncology.See accompanyingEVIDENCE REVIEWAppraisal of the trial report using the GRADE5 in-article on page 3938TROPiCS-023 was an international,randomized,phasestrument was performed as per ASCO's methodologyAuthor affiliationslll tr
