The Japanese Breast Cancer Society Clinical Practice Guidelines for systemic treatment of breast cancer, 2018 edition

Mikiya Ishihara,Toshimi Takano,Yoichi Naito,Fimikata Hara,Rikiya Nakamura,Minoru Miyashita,Naoki Hayashi,Hiroji Iwata,Tatsuya Toyama,Naoto Kondo,Shigehira Saji,Yasuaki Sagara,Tetsuhiro Yoshinami,Masahiro Takada,Junji Tsurutani,Kei Koizumi,Tatsunori Shimoi,Hitoshi Arioka,Toshiro Mizuno,Takashi Yamanaka,Masato Takahashi,Masao Hattori ,Shigenori Nagai ,Yuichiro Kikawa,Nami Yamashita

doi:10.1007/s12282-020-01085-0

Abstract

PurposeWe present the English version of The Japanese Breast Cancer Society (JBCS) Clinical Practice Guidelines for systemic treatment of breast cancer, 2018 edition.MethodsThe JBCS formed a task force to update the JBCS Clinical Practice Guidelines, 2015 edition, according to Minds Handbook for Clinical Practice Guideline Development 2014. First, we set multiple outcomes for each clinical question (CQ). Next, quantitative or qualitative systematic review was conducted for each of the multiple outcomes, and the strength of recommendation for the CQ was taken into consideration during meetings, with the aim of finding a balance between benefit and harm. Finalized recommendations from each session were confirmed through discussion and voting at the recommendation decision meeting.ResultsThe recommendations, the strength of recommendation and the strength of evidence were determined based on systemic literature reviews and the meta-analyses for each CQ.ConclusionThe JBCS updated the Clinical Practice Guidelines for systemic treatment of breast cancer.

Highlights

We present the English version of “The Japanese Breast Cancer Society Clinical Practice Guidelines for systemic treatment of breast cancer, 2018 edition,” which was revised in May 2018, according to Minds Handbook for Clinical Practice Guidelines Development 2014 [1]
Short explanations were added to CQ9; CQ14 (second-line endocrine therapy (ET) for hormone receptor [HR]-positive/human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer in pre- or perimenopausal patients); CQ15; CQ18; and CQ22
The results of this study showed that the epirubicin group was superior to the gemcitabine group in overall survival (OS), time to progression (TTP), and overall response rate (ORR). (6) Vinorelbine To our knowledge, no trials have compared vinorelbine monotherapy with anthracyclines or taxanes as first-line treatments

Summary

Introduction

We present the English version of “The Japanese Breast Cancer Society Clinical Practice Guidelines for systemic treatment of breast cancer, 2018 edition,” which was revised in May 2018, according to Minds Handbook for Clinical Practice Guidelines Development 2014 [1]. The latest version of the guidelines for systemic treatment of breast cancer, 2015 edition, was released but was not based on the Minds Handbook [2]. Strength of recommendation (SoR) and strength of evidence (SoE) on a systematic quantitative and qualitative review according to Minds Handbook for Clinical Practice Guidelines Development 2014 [1, 3]. For each background question (BQ), we have supplied a statement, and for each clinical question (CQ), we have supplied a recommendation, SoR and SoE. Short explanations were added to CQ9 (adjuvant capecitabine combination therapy); CQ14 (second-line endocrine therapy (ET) for hormone receptor [HR]-positive/human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer in pre- or perimenopausal patients); CQ15 (first-line ET for HR-positive/HER2-negative metastatic breast cancer in postmenopausal patients); CQ18 (first-line chemotherapy for HER2-negative metastatic breast cancer); and CQ22 (first-line therapy for HER2positive metastatic breast cancer)

Background questions

Conclusion

Findings

Compliance with ethical standards