The DOI matches its Crossref record; 142 of the 147 references it cites were found in a registry or an index; 48 of the 132 sources its claims cite were checked for support.
5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5)
Open accessAbstract
For the purpose of advanced breast cancer (ABC) guidelines, ABC comprises both inoperable locally advanced breast cancer (LABC) and metastatic breast cancer (MBC).1,2 Advanced/metastatic breast cancer remains a virtually incurable disease, with a median overall survival (OS) of about 3 years and a 5-year survival rate of around 25%,3,4 even in countries without major accessibility problems. Survival is strongly related to breast cancer subtype, with the major advances seen in human epidermal growth factor receptor 2 (HER2)-positive ABC.
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Claims the paper makes
48 of 132 cited sources checked · 21 supported · 0 flagged · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The last 2 years have seen the establishment of cyclin-dependent kinase (CDK)4/6 inhibitors combined with endocrine therapy (ET) as the standard of care for ER-positive/HER2-negative ABC”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [36] Im, 2019, Overall survival with ribociclib plus endocrine therapy in breast cancer, N Engl J Med source
- Partly supportedcites [37] Slamon, 2020, Overall survival with ribociclib plus fulvestrant in advanced breast cancer, N Engl J Med sourceExperimental — accuracy not yet measured
The paper’s Abstract (page not supplied) says CDK4/6 inhibitors have improved outcomes in advanced breast cancer and that three are approved for hormone-receptor-positive, HER2-negative disease. The Discussion (page not supplied) says its findings may support considering ribociclib plus fulvestrant as initial therapy. These passages support the clinical role of the combination, but do not establish that CDK4/6 inhibitors plus endocrine therapy became the standard of care in the stated two-year period. (LLM, conf=0.82)
- Not checked — no full text of the sourcecites [38] Slamon, 2018, Phase III randomized study of ribociclib and fulvestrant in hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer: MONALEESA-3, J Clin Oncol source
- Supportedcites [39] Sledge, 2019, The effect of abemaciclib plus fulvestrant on overall survival in hormone receptor-positive, erbb2-negative breast cancer that progressed on endocrine therapy-MONARCH 2: a randomized clinical trial, JAMA Oncol sourceExperimental — accuracy not yet measured
The paper’s introductory passage (labeled Abstract in our copy) says CDK4/6 inhibitors combined with endocrine therapy have emerged as standard-of-care treatment for HR-positive, HER2-negative advanced breast cancer. This supports the attributed standard-of-care claim. (LLM, conf=0.92)
- Not checked — no full text of the sourcecites [40] Sledge, 2017, MONARCH 2: abemaciclib in combination with fulvestrant in women with HR+/HER2- advanced breast cancer who had progressed while receiving endocrine therapy, J Clin Oncol source
- Not checked — no full text of the sourcecites [41] Tripathy, 2018, Ribociclib plus endocrine therapy for premenopausal women with hormone-receptor-positive, advanced breast cancer (MONALEESA-7): a randomised phase 3 trial, Lancet Oncol source
- Not matchedcites [42] Tripathy, 2018, Cancer Res
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [43] Finn, 2016, Palbociclib and letrozole in advanced breast cancer, N Engl J Med source
- Partly supportedcites [44] Hortobagyi, 2016, Ribociclib as first-line therapy for HR-positive, advanced breast cancer, N Engl J Med sourceExperimental — accuracy not yet measured
The Discussion reports longer progression-free survival with ribociclib plus letrozole than with letrozole alone in postmenopausal women receiving first-line treatment for HR-positive, HER2-negative advanced breast cancer. The paper supports the combination’s efficacy, but does not establish that CDK4/6 inhibitors as a class combined with endocrine therapy had become the standard of care. Its introduction instead identifies endocrine therapy as the standard of care at the time. (LLM, conf=0.87)
- Supportedcites [45] Rugo, 2019, Palbociclib plus letrozole as first-line therapy in estrogen receptor-positive/human epidermal growth factor receptor 2-negative advanced breast cancer with extended follow-up, Breast Cancer Res Treat sourceExperimental — accuracy not yet measured
The Discussion states that international guidelines recommend CDK4/6 inhibitors with endocrine therapy as first-line standard therapy for women with HR-positive/HER2-negative advanced breast cancer. The Introduction also describes this as a recent expansion of treatment guidelines. (LLM, conf=0.92)
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesThe sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Ranges for survival scenarios are also more accurate than a single point estimate of expected survival.16 , 32 , 33”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [16] Smith-Uffen, 2020, Estimating survival in advanced cancer: a comparison of estimates made by oncologists and patients, Support Care Cancer source
- Supportedcites [32] Stockler, 2006, Disarming the guarded prognosis: predicting survival in newly referred patients with incurable cancer, Br J Cancer source
The Discussion recommends talking about survival in ranges rather than single point estimates because predictions were imprecise. The Results show that few patients’ actual survival times were close to their point predictions, supporting that recommendation for newly referred patients with incurable cancer. (LLM, conf=0.87)
- Supportedcites [33] Kiely, 2013, The median informs the message: accuracy of individualized scenarios for survival time based on oncologists' estimates, J Clin Oncol source
The Discussion states that point estimates of survival time were rarely accurate, whereas simple multiples of those estimates accurately described worst-case, typical, and best-case scenarios for patients with advanced cancer. It also explicitly says that providing three scenarios is more accurate than a single point estimate. (LLM, conf=0.94)
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesThe sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“in view of the OS benefit seen in several trials,36, 37, 38, 39, 40, 41, 42 both in the first- and second-line settings”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [36] Im, 2019, Overall survival with ribociclib plus endocrine therapy in breast cancer, N Engl J Med source
- Supportedcites [37] Slamon, 2020, Overall survival with ribociclib plus fulvestrant in advanced breast cancer, N Engl J Med source
The Overall Survival section reports favorable survival estimates with ribociclib plus fulvestrant in both the first-line subgroup and the subgroup receiving second-line therapy or experiencing early relapse. The Discussion says these findings support consideration as initial therapy and suggest benefit in the second-line or early-relapse subgroup. The subgroup estimates were not reported as independently statistically significant. (LLM, conf=0.86)
- Not checked — no full text of the sourcecites [38] Slamon, 2018, Phase III randomized study of ribociclib and fulvestrant in hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer: MONALEESA-3, J Clin Oncol source
- Supportedcites [39] Sledge, 2019, The effect of abemaciclib plus fulvestrant on overall survival in hormone receptor-positive, erbb2-negative breast cancer that progressed on endocrine therapy-MONARCH 2: a randomized clinical trial, JAMA Oncol sourceExperimental — accuracy not yet measured
The Overall Survival section reports a statistically significant survival benefit with abemaciclib plus fulvestrant in HR-positive, ERBB2-negative advanced breast cancer. The Patients section includes women whose disease progressed after adjuvant endocrine therapy or during first-line endocrine therapy for advanced disease. This paper therefore supports its role as one of the trials cited for the broader statement; the sentence does not require every cited trial to establish a benefit in both settings individually. (LLM, conf=0.90)
- Not checked — no full text of the sourcecites [40] Sledge, 2017, MONARCH 2: abemaciclib in combination with fulvestrant in women with HR+/HER2- advanced breast cancer who had progressed while receiving endocrine therapy, J Clin Oncol source
- Not checked — no full text of the sourcecites [41] Tripathy, 2018, Ribociclib plus endocrine therapy for premenopausal women with hormone-receptor-positive, advanced breast cancer (MONALEESA-7): a randomised phase 3 trial, Lancet Oncol source
- Not matchedcites [42] Tripathy, 2018, Cancer Res
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesEvery source the paper cites for this claim was checked and supports it.
In the paper
“Most patients want considerably more information than many healthcare professionals expect, but the type and amount of information sought should be clarified.23”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Supportedcites [23] Jenkins, 2001, Information needs of patients with cancer: results from a large study in UK cancer centres, Br J Cancer source
The Discussion (page not provided) reports that 95% of surveyed patients wanted to know their chances of cure and says prognosis information should not be avoided. The paper also states that clinicians tend to underestimate patients’ information needs and recommends checking each patient’s preferences directly. (LLM, conf=0.90)
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The study demonstrated a PFS benefit favouring the veliparib arm, with a median PFS of 14.5 versus 12.6 months (HR 0.71; 95% CI 0.57-0.88, P = 0.002)”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Supportedcites [79] Dieras, 2019, Phase 3 study of veliparib with carboplatin and paclitaxel in HER2-negative advanced/metastatic gBRCA-associated breast cancer, Ann Oncol source
The efficacy table in the Abstract (p. v857) reports investigator-assessed median PFS of 14.5 months with veliparib plus carboplatin/paclitaxel versus 12.6 months with placebo plus carboplatin/paclitaxel, with HR 0.71 (95% CI 0.57–0.88; P=0.002). The Conclusions also describe a significant PFS improvement. (LLM, conf=0.95)
Strength:boosted· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“an analysis was conducted and presented, and showed an OS of 25 months versus 15.1 months favouring the atezolizumab arm.”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Partly supportedcites [68] Schmid, 2018, Atezolizumab and nab-paclitaxel in advanced triple-negative breast cancer, N Engl J Med sourceExperimental — accuracy not yet measured
The Interim Overall Survival Analysis reports median overall survival of 25.0 months with atezolizumab plus nab-paclitaxel versus 15.5 months with placebo plus nab-paclitaxel in the PD-L1-positive subgroup—not 15.1 months. It also says formal testing of overall survival in that subgroup was not conducted at this interim analysis. (LLM, conf=0.91)
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“SP263 (Ventana) and 22-C3 (Dako), both of which are widely used in pathology laboratories for other tumour types, have been evaluated for their clinical validity in the context of the IMpassion-130 trial but failed to reproduce SP142 clinical validity.90”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Supportedcites [90] Rugo, 2019, Performance of PD-L1 immunohistochemistry (IHC) assays in unresectable locally advanced or metastatic triple-negative breast cancer (mTNBC): post-hoc analysis of IMpassion130, Ann Oncol source
The Results and Conclusions (Annals of Oncology, p. v859) show that, at the evaluated cutoffs, 22C3 and SP263 identified more PD-L1-positive patients than SP142, while the SP142-positive population derived the greatest clinical benefit. This supports the claim that the other assays did not reproduce SP142’s clinical patient selection in the IMpassion130 analysis. (LLM, conf=0.86)
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“these can be discontinued after 4 weeks as the risk of rash is primarily in the first 2 weeks of therapy.”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Partly supportedcites [59] Nunnery, 2019, Management of toxicity to isoform α-specific PI3K inhibitors, Ann Oncol sourceExperimental — accuracy not yet measured
The Rash section (page unavailable) says alpelisib rash typically begins within the first two months of treatment. It does not establish that the risk is primarily confined to the first two weeks or recommend stopping prophylaxis after four weeks. (LLM, conf=0.82)
- Not checked — no full text of the sourcecites [60] Rugo, 2020, J Clin Oncol source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In the PIK3CA-mutated cohort, alpelisib provided a PFS benefit of 11.0 months versus 5.7 months [hazard ratio (HR) for progression or death: 0.65; 95% confidence interval (CI) 0.50-0.85, P < 0.001].”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Supportedcites [58] André, 2019, Alpelisib for PIK3CA-mutated, hormone receptor-positive advanced breast cancer, N Engl J Med source
The ‘Efficacy of Alpelisib-Fulvestrant in the Cohort with PIK3CA-Mutated Cancer’ section reports median progression-free survival of 11.0 months with alpelisib–fulvestrant versus 5.7 months with placebo–fulvestrant. It also gives the cited hazard ratio, confidence interval, and P value. (LLM, conf=0.95)
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Only 20 patients (6%) in SOLAR-1 had been previously exposed to a CDK4/6 inhibitor.”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Partly supportedcites [58] André, 2019, Alpelisib for PIK3CA-mutated, hormone receptor-positive advanced breast cancer, N Engl J Med sourceExperimental — accuracy not yet measured
Table 1 (Characteristics of the Patients at Baseline) reports prior CDK4/6 inhibitor treatment in 9 and 11 patients in the two PIK3CA-mutated groups: 20 of 341 patients, or about 6%. The claim omits that cohort restriction; across all four SOLAR-1 groups, the table reports 35 previously treated patients. (LLM, conf=0.88)
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Partly supported
- It may state two separate claims as one. 29
- Probably not a substantial claim. 8
- The quote only partly states this claim. 1
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Misunderstandings about prognosis are common16, 17, 18 and are associated with increased exposure to futile treatments.19, 20, 21, 22”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [16] Smith-Uffen, 2020, Estimating survival in advanced cancer: a comparison of estimates made by oncologists and patients, Support Care Cancer source
- Not checked — no full text of the sourcecites [17] Hagerty, 2005, Communicating prognosis in cancer care: a systematic review of the literature, Ann Oncol source
- Not checked — no full text of the sourcecites [18] Fried, 2003, Prognosis communication in serious illness: perceptions of older patients, caregivers, and clinicians, J Am Geriatr Soc source
- Partly supportedcites [19] Mack, 2012, Associations between end-of-life discussion characteristics and care received near death: a prospective cohort study, J Clin Oncol sourceExperimental — accuracy not yet measured
The Abstract reports that earlier end-of-life discussions were associated with less aggressive care in patients with stage IV lung or colorectal cancer. But the Discussion says the study did not assess discussion content, and its care measures could not distinguish beneficial from ineffective treatment. It therefore does not establish that misunderstandings about prognosis were associated with futile treatment. (LLM, conf=0.85)
- Partly supportedcites [20] Wright, 2008, Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment, JAMA sourceExperimental — accuracy not yet measured
The Discussion (page unavailable) says cancer patients frequently misunderstand or fail to recall prognostic discussions. The Results (Medical care at the end-of-life; page unavailable) associate reported end-of-life discussions with fewer aggressive interventions near death, but the study does not establish that prognostic misunderstandings themselves are associated with greater exposure to treatment, or characterize those treatments as futile. (LLM, conf=0.85)
- Not checked — no full text of the sourcecites [21] Weeks, 1998, Relationship between cancer patients' predictions of prognosis and their treatment preferences, JAMA source
- Not checked — no full text of the sourcecites [22] Pronzato, 1994, What do advanced cancer patients know of their disease? A report from Italy, Support Care Cancer source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“substantial PFS benefit and good toxicity profile.36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [36] Im, 2019, Overall survival with ribociclib plus endocrine therapy in breast cancer, N Engl J Med source
- Partly supportedcites [37] Slamon, 2020, Overall survival with ribociclib plus fulvestrant in advanced breast cancer, N Engl J Med sourceExperimental — accuracy not yet measured
The Progression-free Survival section reports a substantial benefit for ribociclib plus fulvestrant over placebo plus fulvestrant in patients with advanced breast cancer. The Adverse Events section reports no new safety signals, but adverse events were more frequent with ribociclib, including grade 3 or 4 neutropenia in 57.1% versus 0.8%; it does not establish the claimed good toxicity profile. The trial also addresses this specific combination, not CDK4/6 inhibitors as a class. (LLM, conf=0.87)
- Not checked — no full text of the sourcecites [38] Slamon, 2018, Phase III randomized study of ribociclib and fulvestrant in hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer: MONALEESA-3, J Clin Oncol source
- Partly supportedcites [39] Sledge, 2019, The effect of abemaciclib plus fulvestrant on overall survival in hormone receptor-positive, erbb2-negative breast cancer that progressed on endocrine therapy-MONARCH 2: a randomized clinical trial, JAMA Oncol sourceExperimental — accuracy not yet measured
In Other Exploratory End Points (page not provided), abemaciclib plus fulvestrant improved median PFS to 16.9 months versus 9.3 months with placebo plus fulvestrant. The Discussion (page not provided) describes its safety profile as generally tolerable and manageable. The paper supports these points for abemaciclib plus fulvestrant in the studied patients, but not for CDK4/6 inhibitors plus endocrine therapy as a class. (LLM, conf=0.85)
- Not checked — no full text of the sourcecites [40] Sledge, 2017, MONARCH 2: abemaciclib in combination with fulvestrant in women with HR+/HER2- advanced breast cancer who had progressed while receiving endocrine therapy, J Clin Oncol source
- Not checked — no full text of the sourcecites [41] Tripathy, 2018, Ribociclib plus endocrine therapy for premenopausal women with hormone-receptor-positive, advanced breast cancer (MONALEESA-7): a randomised phase 3 trial, Lancet Oncol source
- Not matchedcites [42] Tripathy, 2018, Cancer Res
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [43] Finn, 2016, Palbociclib and letrozole in advanced breast cancer, N Engl J Med source
- Partly supportedcites [44] Hortobagyi, 2016, Ribociclib as first-line therapy for HR-positive, advanced breast cancer, N Engl J Med sourceExperimental — accuracy not yet measured
The Discussion reports significantly longer progression-free survival with ribociclib plus letrozole and describes its adverse-event profile as acceptable for most patients. But this trial studied one CDK4/6 inhibitor with one endocrine therapy in postmenopausal women with HR-positive, HER2-negative advanced breast cancer; it does not establish the same benefit and toxicity profile for all CDK4/6 inhibitor–endocrine therapy combinations. (LLM, conf=0.86)
- Supportedcites [45] Rugo, 2019, Palbociclib plus letrozole as first-line therapy in estrogen receptor-positive/human epidermal growth factor receptor 2-negative advanced breast cancer with extended follow-up, Breast Cancer Res Treat source
The Discussion reports substantial PFS benefit from adding palbociclib to letrozole, and the Conclusions report improved PFS across clinically relevant subgroups. The Safety section reports no new safety signals with extended follow-up, although adverse events were more frequent than with placebo-letrozole. This paper supports the claim for palbociclib plus endocrine therapy in the studied breast-cancer setting. (LLM, conf=0.89)
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Importantly, a reduction in the risk of CNS progression or death by 69% was observed in patients with stable brain metastases, while a confirmed objective response rate of 47% and a reduced risk of death by 51% were observed in patients with active brain metastases.63”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Partly supportedcites [63] Lin, 2020, Intracranial efficacy and survival with tucatinib plus trastuzumab and capecitabine for previously treated HER2-positive breast cancer with brain metastases in the HER2CLIMB trial, J Clin Oncol sourceExperimental — accuracy not yet measured
The Results sections for stable and active brain metastases report the 69% reduction in CNS progression or death and the 51% reduction in death, respectively. The Results also report a 47.3% confirmed intracranial response rate, but only among patients with active brain metastases who had measurable intracranial disease at baseline; the claim omits that restriction. (LLM, conf=0.86)
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In the ITT population, there was no significant benefit in OS with the addition of atezolizumab; median OS was 21.3 months versus 17.6 months (HR 0.84; 95% CI 0.69-1.02, P = 0.08).”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Supportedcites [68] Schmid, 2018, Atezolizumab and nab-paclitaxel in advanced triple-negative breast cancer, N Engl J Med source
The Interim Overall Survival Analysis reports the first interim analysis in the intention-to-treat population: median overall survival was 21.3 months with atezolizumab plus nab-paclitaxel versus 17.6 months with placebo plus nab-paclitaxel, with HR 0.84, 95% CI 0.69–1.02, and P=0.08, explicitly marked not significant. The claim accurately describes that interim result. (LLM, conf=0.95)
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“These agents can be combined with an aromatase inhibitor (AI) or fulvestrant, and are effective in de novo or recurrent ABC, in first or second line, in cases of primary or secondary resistance, in postmenopausal and premenopausal women (the latter with ovarian function suppression/ablation), and in men (preferably with a luteinising hormone-releasing hormone agonist).”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [36] Im, 2019, Overall survival with ribociclib plus endocrine therapy in breast cancer, N Engl J Med source
- Partly supportedcites [37] Slamon, 2020, Overall survival with ribociclib plus fulvestrant in advanced breast cancer, N Engl J Med sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Not checked — no full text of the sourcecites [38] Slamon, 2018, Phase III randomized study of ribociclib and fulvestrant in hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer: MONALEESA-3, J Clin Oncol source
- Partly supportedcites [39] Sledge, 2019, The effect of abemaciclib plus fulvestrant on overall survival in hormone receptor-positive, erbb2-negative breast cancer that progressed on endocrine therapy-MONARCH 2: a randomized clinical trial, JAMA Oncol sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Not checked — no full text of the sourcecites [40] Sledge, 2017, MONARCH 2: abemaciclib in combination with fulvestrant in women with HR+/HER2- advanced breast cancer who had progressed while receiving endocrine therapy, J Clin Oncol source
- Not checked — no full text of the sourcecites [41] Tripathy, 2018, Ribociclib plus endocrine therapy for premenopausal women with hormone-receptor-positive, advanced breast cancer (MONALEESA-7): a randomised phase 3 trial, Lancet Oncol source
- Not matchedcites [42] Tripathy, 2018, Cancer Res
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [43] Finn, 2016, Palbociclib and letrozole in advanced breast cancer, N Engl J Med source
- Partly supportedcites [44] Hortobagyi, 2016, Ribociclib as first-line therapy for HR-positive, advanced breast cancer, N Engl J Med sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Partly supportedcites [45] Rugo, 2019, Palbociclib plus letrozole as first-line therapy in estrogen receptor-positive/human epidermal growth factor receptor 2-negative advanced breast cancer with extended follow-up, Breast Cancer Res Treat sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Trastuzumab deruxtecan was associated with a 13.6% risk of interstitial lung disease (ILD)/pneumonitis, fatal in 2.2% of cases, which needed appropriate and rapid diagnosis and treatment.”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Partly supportedcites [64] Modi, 2020, Trastuzumab deruxtecan in previously treated HER2-positive breast cancer, N Engl J Med sourceExperimental — accuracy not yet measured
The Results > Safety passage reports ILD in 25 patients (13.6%) and four ILD-attributed deaths (2.2% of all treated patients). The claim's “fatal in 2.2% of cases” is imprecise: if “cases” means patients who developed ILD, the fatal proportion was four of 25, not 2.2%. The Discussion supports early detection and prompt intervention. (LLM, conf=0.86)
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Thus, PD-L1 status by SP142 is the companion test for the use of atezolizumab in combination with a taxane for first-line therapy in triple-negative ABC, with a cut-off of 1% positive staining on immune cells.”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Partly supportedcites [68] Schmid, 2018, Atezolizumab and nab-paclitaxel in advanced triple-negative breast cancer, N Engl J Med sourceExperimental — accuracy not yet measured
Trial Design and Procedures (page not provided) defines PD-L1 positivity as expression on tumor-infiltrating immune cells covering at least 1% of tumor area, and the Discussion reports first-line benefit with atezolizumab plus nab-paclitaxel. The paper does not establish SP142 as a companion test in its trial description; SP142 appears in a reference to a *complementary* diagnostic assay. The claim also broadens nab-paclitaxel to taxanes generally and describes the cutoff as 1% of immune cells staining positive rather than 1% of tumor area. (LLM, conf=0.88)
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Trastuzumab deruxtecan (DS-8201), an ADC composed of trastuzumab, a cleavable tetrapeptide-based linker and a cytotoxic topoisomerase I inhibitor, demonstrated a response rate of 60.6% (95% CI 53.4-68.0) and an unprecedented median PFS of 16.4 months (95% CI 12.7—not reached) in a phase II study of heavily pretreated patients (median six lines, range 2-27 lines, including trastuzumab and T-DM1).64”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Partly supportedcites [64] Modi, 2020, Trastuzumab deruxtecan in previously treated HER2-positive breast cancer, N Engl J Med sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Toxicity was substantially increased in the alpelisib arm, especially hyperglycaemia, rash, gastrointestinal (GI) complaints (nausea, vomiting, loss of appetite, mucositis, diarrhoea) and fatigue, which lead to dose reductions/interruptions in around 70% of patients and discontinuations in 25%.”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Supportedcites [58] André, 2019, Alpelisib for PIK3CA-mutated, hormone receptor-positive advanced breast cancer, N Engl J Med source
The Safety section reports higher rates of hyperglycemia, rash, diarrhea, nausea, and decreased appetite with alpelisib–fulvestrant, and 25.0% discontinued alpelisib because of adverse events. The adverse-event table also reports more vomiting, mucosal inflammation, and fatigue; the treatment passage reports dose interruptions in 74.0% and reductions in 63.9% of patients in the PIK3CA-mutated cohort. Page numbers were not provided in our copy. (LLM, conf=0.91)
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Sleep disturbances may be treated with melatonin.122 , 123”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Supportedcites [122] Chen, 2014, A randomized, placebo-controlled trial of melatonin on breast cancer survivors: impact on sleep, mood, and hot flashes, Breast Cancer Res Treat source
The Discussion reports that melatonin improved sleep in a randomized trial of breast cancer survivors. It also describes evidence of efficacy for insomnia and other sleep problems, supporting the broader, hedged claim that melatonin may treat sleep disturbances. Page numbers were not provided in the supplied passages. (LLM, conf=0.94)
- Not checked — no full text of the sourcecites [123] Innominato, 2016, The effect of melatonin on sleep and quality of life in patients with advanced breast cancer, Support Care Cancer source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“For menopausal symptoms in general, mind-body interventions, physical training and cognitive behavioural therapy should be recommended as effective non-pharmacological treatment options.113, 114, 115, 116, 117”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [113] Duijts, 2012, Efficacy of cognitive behavioral therapy and physical exercise in alleviating treatment-induced menopausal symptoms in patients with breast cancer: results of a randomized, controlled, multicenter trial, J Clin Oncol source
- Partly supportedcites [114] Mann, 2012, Cognitive behavioural treatment for women who have menopausal symptoms after breast cancer treatment (MENOS 1): a randomised controlled trial, Lancet Oncol sourceExperimental — accuracy not yet measured
The Discussion (page unavailable) reports sustained benefits from CBT for hot flushes and night sweats in women after breast cancer treatment and calls it an effective treatment option for that group. It mentions only preliminary findings from a separate CBT-and-exercise trial; it does not establish physical training or mind-body interventions as independently effective, or extend its recommendation to menopausal symptoms in general. (LLM, conf=0.88)
- Partly supportedcites [115] Stefanopoulou, 2017, Mind-body interventions for vasomotor symptoms in healthy menopausal women and breast cancer survivors. A systematic review, J Psychosom Obstet Gynaecol sourceExperimental — accuracy not yet measured
The Conclusion (p. 15) supports recommending CBT for vasomotor symptoms and reports more consistent evidence for relaxation therapies. It also says evidence is insufficient to treat several other mind-body interventions as evidence-based options. The review does not establish physical training as effective, and its findings concern vasomotor symptoms rather than menopausal symptoms in general. (LLM, conf=0.90)
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“there is evidence that some oncologists are overly optimistic about survival benefits from anticancer treatments while others are unduly nihilistic about the benefits of good quality supportive care.34”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [34] Fallowfield, 2017, Therapeutic aims of drugs offering only progression-free survival are misunderstood by patients, and oncologists may be overly optimistic about likely benefits, Support Care Cancer source
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“For patients wanting quantitative information on life expectancy, providing ranges for worst-case, typical and best-case scenarios is more helpful and conveys more hope than providing a single point estimate of median survival.31”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [31] Kiely, 2013, Using scenarios to explain life expectancy in advanced cancer: attitudes of people with a cancer experience, Support Care Cancer source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“The available data show that bevacizumab combined with ChT as first-line therapy for ABC provides a moderate benefit in progression-free survival (PFS) and no benefit in OS.”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [35] Hey, 2020, A systematic review and meta-analysis of bevacizumab in first-line metastatic breast cancer: lessons for research and regulatory enterprises, J Natl Cancer Inst source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“The ESMO-MCBS v1.1 score for bevacizumab is two.35”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [35] Hey, 2020, A systematic review and meta-analysis of bevacizumab in first-line metastatic breast cancer: lessons for research and regulatory enterprises, J Natl Cancer Inst source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe quote only partly states this claim.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Although some physicians may avoid discussing prognosis for fear of upsetting the patient or destroying hope, there is no evidence that increased information about prognosis with sensitive communication is harmful to patients, or that it increases anxiety or distress.25, 26, 27, 28, 29, 30”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [25] Fallowfield, 2002, Truth may hurt but deceit hurts more: communication in palliative care, Palliat Med source
- Not checked — no full text of the sourcecites [26] Barnett, 2006, Does it hurt to know the worst?–psychological morbidity, information preferences and understanding of prognosis in patients with advanced cancer, Psychooncology source
- Not checked — no full text of the sourcecites [27] Enzinger, 2015, Outcomes of prognostic disclosure: associations with prognostic understanding, distress, and relationship with physician among patients with advanced cancer, J Clin Oncol source
- Not checked — no full text of the sourcecites [28] Gattellari, 2002, When the treatment goal is not cure: are cancer patients equipped to make informed decisions?, J Clin Oncol source
- Not checked — no full text of the sourcecites [29] Hagerty, 2005, Communicating with realism and hope: incurable cancer patients' views on the disclosure of prognosis, J Clin Oncol source
- Not checked — no full text of the sourcecites [30] Smith, 2010, Giving honest information to patients with advanced cancer maintains hope, Oncology (Williston Park)
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Previous ABC recommendations that did not require update or only minor changes were not re-voted but were reviewed by all panel members by e-mail and remain valid.”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Tucatinib, a highly selective inhibitor of the HER2 tyrosine kinase, used in combination with capecitabine and trastuzumab in a population of ABC patients pretreated with trastuzumab, pertuzumab and trastuzumab emtansine (T-DM1), demonstrated improvement of PFS (median 7.8 months versus 5.6 months, HR 0.54; 95% CI 0.42-0.71, P < 0.001) and OS (median 21.9 months versus 17.4 months, HR 0.66; 95% CI”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [62] Murthy, 2020, Tucatinib, trastuzumab, and capecitabine for HER2-positive metastatic breast cancer, N Engl J Med source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Furthermore, the NALA study has a severe limitation of not having a comparator arm with trastuzumab plus capecitabine, which was previously shown to provide superior OS to lapatinib plus capecitabine in the first- and second-line settings.67”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [67] Pivot, 2015, CEREBEL (EGF111438): a phase III, randomized, open-label study of lapatinib plus capecitabine versus trastuzumab plus capecitabine in patients with human epidermal growth factor receptor 2-positive metastatic breast cancer, J Clin Oncol source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Neratinib provided a small reduction in the risk of disease progression of 24% (95% CI 0.63-0.93; P = 0.006, medians not provided), a marginal difference in PFS and no impact on OS (co-primary end point) compared with lapatinib (both in combination with capecitabine), at the cost of increased toxicity.66”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [66] Saura, 2019, Neratinib + capecitabine versus lapatinib + capecitabine in patients with HER2+ metastatic breast cancer previously treated with ≥ 2 HER2-directed regimens: findings from the multinational, randomized, phase III NALA trial, J Clin Oncol source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“They may share morphological (high grade, poor differentiation)92 and biological features93 , 94 with TNBC and experience a similarly poor survival.95 , 96”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [92] Gloyeske, 2014, Low ER+ breast cancer: is this a distinct group?, Am J Clin Pathol source
- Not checked — no full text of the sourcecites [93] Deyarmin, 2013, Effect of ASCO/CAP guidelines for determining ER status on molecular subtype, Ann Surg Oncol source
- Not checked — no full text of the sourcecites [94] Iwamoto, 2012, Estrogen receptor (ER) mRNA and ER-related gene expression in breast cancers that are 1% to 10% ER-positive by immunohistochemistry, J Clin Oncol source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All panel members were instructed to vote on all questions, and any members with a potential conflict of interest or who did not feel comfortable answering the question (e.g. due to lack of expertise in a particular field) were instructed to vote ‘abstain’.”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Statements related to the management of side-effects and difficult symptoms, included under the supportive and palliative care section, were not voted on during the consensus session, but were discussed and unanimously agreed by e-mail, and are therefore considered to have 100% consensus agreement.”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“This was achieved at the expense of increased toxicity, mostly diarrhoea and elevated aminotransferase levels of grade ≥3, but did not lead to frequent treatment discontinuation.”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [62] Murthy, 2020, Tucatinib, trastuzumab, and capecitabine for HER2-positive metastatic breast cancer, N Engl J Med source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Margetuximab resulted in only a 0.9-month PFS prolongation (HR 0.76; 95% CI 0.59-0.98, P = 0.033) compared with trastuzumab (both combined with ChT of physician's choice), no OS benefit and a good toxicity profile.65”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [65] Rugo, 2019, SOPHIA primary analysis: a phase 3 (P3) study of margetuximab (M) + chemotherapy (C) versus trastuzumab (T) + C in patients (pts) with HER2+ metastatic (met) breast cancer (MBC) after prior anti-HER2 therapies (Tx), J Clin Oncol source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“The overall response rate was 33.3% (95% CI 24.6-43.1), with a median duration of response of 7.7 months (95% CI 4.9-10.8).”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [72] Bardia, 2019, Sacituzumab govitecan-hziy in refractory metastatic triple-negative breast cancer, N Engl J Med source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Of the patients with a response to sacituzumab govitecan-hziy, 55.6% maintained their response for ≥6 months and 16.7% maintained their response for ≥12 months.”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [72] Bardia, 2019, Sacituzumab govitecan-hziy in refractory metastatic triple-negative breast cancer, N Engl J Med source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Recently, these data were updated showing a PFS difference of 2.5 months and an OS difference of 7 months in the PD-L1-positive population.69”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [69] Schmid, 2020, Atezolizumab plus nab-paclitaxel as first-line treatment for unresectable, locally advanced or metastatic triple-negative breast cancer (IMpassion130): updated efficacy results from a randomised, double-blind, placebo-controlled, phase 3 trial, Lancet Oncol source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“LMD carries a poor prognosis, with a median OS of approximately 4 weeks which can be prolonged to a few months in some patients with aggressive multimodal treatment.100”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [100] Franzoi, 2019, Leptomeningeal carcinomatosis in patients with breast cancer, Crit Rev Oncol Hematol source
Strength:plain· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Recently, the ASCO-College of American Pathologists (CAP) guidelines acknowledged that patients with tumours between 1% and 10% of ER staining represent a new reporting category, stipulating the lack of data concerning benefit from ET and the proximity to ER-negative breast cancer of this patient group.98”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [98] Allison, 2020, Estrogen and progesterone receptor testing in breast cancer: ASCO/CAP Guideline update, J Clin Oncol source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
In the paper
“decreased or no interest in sexual activity was frequently reported with a significant association to less satisfaction and more discomfort (dyspareunia)”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [124] Mayer, 2019, Sexual activity and quality of life in patients after treatment for breast and ovarian cancer, Arch Gynecol Obstet source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“however, the lack of desire was not associated with global health status, QoL or the ability to experience orgasms”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [124] Mayer, 2019, Sexual activity and quality of life in patients after treatment for breast and ovarian cancer, Arch Gynecol Obstet source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Several organisations, such as ASCO,108 have been calling for measures to ensure adequate protection of cancer patients.”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [108] Page, 2019, Opioids and cancer pain: patients' needs and access challenges, J Oncol Pract source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Yet, in Europe and all over the world, there is inadequate and very unequal access to pain control,105”
§ 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) > Methodology
What the sources say
- Not checked — no full text of the sourcecites [105] Knaul, 2018, Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the Lancet Commission report, Lancet source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
The authors state this as an assumption.
The ABC 5 guidelines assume accessibility to all available therapies.
“assuming accessibility to all available therapies”
The paper relies on this without support.
Visceral crisis occurs in about 10-15% of first-line ABC cases.
“This situation is estimated to occur in only around 10%-15% of first-line ABC cases”
The paper relies on this without support.
No biomarkers currently enable accurate identification of patients who can be treated with endocrine therapy alone.
“There are currently no biomarkers to enable accurate identification of these patients.”
The paper relies on this without support.
There are no comparative data between the four new anti-HER2 agents (tucatinib, trastuzumab deruxtecan, margetuximab, neratinib).
“there are no comparative data between these four new anti-HER2 agents”
The paper relies on this without support.
The optimal sequence of treatments after trastuzumab, pertuzumab and T-DM1 is currently unknown.
“the question regarding the optimal sequence of treatments after trastuzumab, pertuzumab and T-DM1 is currently unknown.”
The paper relies on this without support.
Triple-negative advanced breast cancer is clinically and molecularly not one but many diseases.
“with the recognition that both clinically and molecularly this is not one but many diseases.”
The paper relies on this without support.
For most patients, chemotherapy remains the only available non-investigational systemic treatment option for non-BRCA-mutated triple-negative advanced breast cancer.
“For most patients, ChT remains the only available non-investigational systemic treatment option for non-BRCA-mutated triple-negative ABC”
The paper relies on this without support.
At present, only germline mutations in BRCA1/2 have clinical utility and therapeutic impact.
“However, at present, only germline mutations in BRCA1/2 have any clinical utility and therapeutic impact.”
The paper relies on this without support.
A mutation in another moderate- to high-penetrance gene has limited clinical implications in advanced breast cancer.
“a mutation in another moderate- to high-penetrance gene has limited clinical implications in the setting of ABC”
The paper relies on this without support.
The majority of PIK3CA mutations affect hot spots in exons 9 and 20.
“The majority of PIK3CA mutations affect hot spots i.e. the three most frequent in exons 9 and 20”
The paper relies on this without support.
PIK3CA mutations are present in up to 40% of metastatic luminal breast cancer.
“They are present in up to 40% of metastatic luminal breast cancer.”
The paper relies on this without support.
PIK3CA mutations activate the alpha isoform of PI3K and drive oncogenicity.
“The mutations activate the alpha isoform of PI3K and drive oncogenicity.”
The paper relies on this without support.
Acquisition of ESR1 mutations is frequent in advanced breast cancer patients previously treated with aromatase inhibitors (20%-40%) and is one mechanism of resistance to hormonal therapies.
“Acquisition of ESR1 mutations, frequent in ABC patients previously treated by AIs (20%-40%), is one of the mechanisms of resistance to hormonal therapies.”
The paper relies on this without support.
ESR1 mutations cause ligand-independent, constitutive activity of the estrogen receptor.
“The consequence is a ligand-independent, constitutive activity of ER.”
The paper relies on this without support.
Leptomeningeal disease is a rare complication of breast cancer with a 5% incidence rate.
“Leptomeningeal disease (LMD) is a rare complication of breast cancer with a 5% incidence rate.”
The paper relies on this without support.
Currently, there is no accepted standard of care for breast cancer leptomeningeal disease.
“Currently, there is no accepted standard of care for breast cancer LMD and recommendations are essentially expert opinion-based.”
The paper relies on this without support.
Many therapies for advanced breast cancer are associated with estrogen deprivation and patients often suffer from menopausal symptoms.
“Many therapies for ABC are associated with estrogen deprivation and patients often suffer from menopausal symptoms”
The paper relies on this without support.
Hormone replacement therapy is contraindicated due to the endocrine character of the disease.
“Hormone replacement therapy is contraindicated due to the endocrine character of the disease”
The paper relies on this without support.
Dyspareunia is often caused by vaginal dryness.
“Dyspareunia is often caused by vaginal dryness.”
The paper relies on this without support.
At first recurrence, one out of four patients is younger than 50 years old and premenopausal.
“At first recurrence, one out of four patients is younger than 50 years old and premenopausal.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The use of CDK4/6 inhibitors (ribociclib, abemaciclib, and palbociclib) improved progression-free survival in this patient population, leading to regulatory approvals. 9-13”
From Overall Survival with Ribociclib plus Letrozole in Advanced Breast Cancer. (2022) · cites this paper as [12]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“In patients with HR–positive and HER2–negative recurrent or metastatic breast cancer, endocrine therapy combined with CDK4/6 inhibitors has been established as the current standard of care.2)”
From Liver Resection after Disease Control with Abemaciclib for Solitary Liver Metastasis from Breast Cancer: A Case Report (2026) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“As CDK4/6 inhibitor (CDK4/6i) + endocrine therapy (ET) is now a preferred option for 1L HR+/HER2− ABC”
In the citing paper
“Endocrine therapy is the backbone of systemic treatment for advanced hormone receptor (HR)–positive, human epidermal growth factor receptor 2 (HER2)–negative breast cancer.1”
Citations
Cites
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.21492 · Cited by 84,109 · cited 25×
“Therefore, all ChT recommendations for HER2-negative disease also apply for triple-negative ABC.”
BackgroundInfluentialAtezolizumab and nab-paclitaxel in advanced triple-negative breast cancer
Schmid, P., Adams, S., Rugo, H. S., Schneeweiss, A., Barrios, C. H., Iwata, H., Diéras, V., Hegg, R., Im, S.-A., Shaw Wright, G., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1809615 · Cited by 4,350 · cited 2×
“Based on these data, atezolizumab in combination with nabpaclitaxel was approved and may be considered an option in the first-line setting for de novo advanced/metastatic disease or disease that has developed at least 12 months after completion of (neo)adjuvant ChT in tumours that have PD-L1 expression 1% based on sta…”
MethodSelf-citationOlaparib for Metastatic Breast Cancer in Patients with a Germline BRCA Mutation
Robson, M., Im, S.-A., Senkus, E., Xu, B., Domchek, S. M., Masuda, N., Delaloge, S., Li, W., Tung, N., Armstrong, A., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1706450 · Cited by 3,294 · cited 1×
“02) in a subgroup analysis of predefined stratification subgroups,(75) lending further support to existing data for a PFS benefit with olaparib in the ITT population of the study.(76) The EMBRACA study(77) had a similar design to the OlympiAD study, comparing talazoparib with ChT monotherapy per physician’s choice (ca…”
ResultSelf-citationHarbeck, N., Penault-Llorca, F., Cortes, J., Gnant, M., Houssami, N., Poortmans, P., Ruddy, K., Tsang, J., & Cardoso, F. (2019) · Nature Reviews Disease Primers · doi:10.1038/s41572-019-0111-2 · Cited by 3,024 · cited 2×
“Few (88) of these patients were treated in the CLEOPATRA trial and all with a trastuzumabfree interval >12 months.”
BackgroundSelf-citationPalbociclib and letrozole in advanced breast cancer
Finn, R. S., Martin, M., Rugo, H. S., Jones, S., Im, S.-A., Gelmon, K., Harbeck, N., Lipatov, O. N., Walshe, J. M., Moulder, S., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1607303 · Cited by 3,007 · cited 1×
“The last 2 years have seen the establishment of cyclindependent kinase (CDK)4/6 inhibitors combined with endocrine therapy (ET) as the standard of care for ER-positive/HER2-negative ABC in view of the OS benefit seen in several trials,(36-42) both in the first- and second-line settings, substantial PFS benefit and goo…”
BackgroundSelf-citationWright, A. A. (2008) · JAMA · doi:10.1001/jama.300.14.1665 · Cited by 2,788
Alpelisib for PIK3CA -Mutated, Hormone Receptor–Positive Advanced Breast Cancer
André, F., Ciruelos, E., Rubovszky, G., Campone, M., Loibl, S., Rugo, H. S., Iwata, H., Conte, P., Mayer, I. A., Kaufman, B., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1813904 · Cited by 2,622 · cited 2×
“The SOLAR-1 phase III, randomised, placebo-controlled trial evaluated the role of alpelisib, an oral inhibitor of the phosphoinositide 3-kinase alpha (PI3Ka) isoform, in combination with fulvestrant, for postmenopausal women andmenwhohad previously been treated with an AI.(58) In the PIK3CA-mutated cohort, alpelisib p…”
MethodInfluentialSelf-citationWolff, A. C., Hammond, M. E. H., Allison, K. H., Harvey, B. E., Mangu, P. B., Bartlett, J. M. S., Bilous, M., Ellis, I. O., Fitzgibbons, P. L., Hanna, W. M., et al. (2018) · Journal of Clinical Oncology · doi:10.1200/jco.2018.77.8738 · Cited by 2,449 · cited 2×
“Tumours with staining of ER <1% and progesterone receptor (PgR)<1%andwithHER2-negative results by IHC and/ or in situ hybridisation are defined as TNBC.(91) Patients with a low (1%-10%) expression of hormone receptors and HER2negative account for 2%-3% of breast cancers.”
Liquid Biopsies: Genotyping Circulating Tumor DNA
Diaz, L. A., & Bardelli, A. (2014) · Journal of Clinical Oncology · doi:10.1200/jco.2012.45.2011 · Cited by 2,210 · cited 1×
“Different technologies are available from single-gene assay by quantitative polymerase chain reaction (qPCR) to whole genome sequencing by next-generation sequencing (NGS).(80,81) Standardisation is a critical point, especially for NGS-based analysis.”
MethodTalazoparib in Patients with Advanced Breast Cancer and a Germline BRCA Mutation
Litton, J. K., Rugo, H. S., Ettl, J., Hurvitz, S. A., Gonçalves, A., Lee, K.-H., Fehrenbacher, L., Yerushalmi, R., Mina, L. A., Martin, M., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1802905 · Cited by 2,175
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“The current treatment strategies for breast cancer, as outlined by the 5th ESO-ESMO International Consensus Guidelines, encompass a combination of chemotherapy, radiotherapy, targeted therapy, immunotherapy, and endocrine therapy [2].”
Filonenko, D., Ibragimova, T., Ивановна, П. Н., Belogurova, A. V., Khatkova, E. I., Arutyunyan, E. A., Volkova, E., & Zhukova, L. (2021) · Meditsinskiy sovet = Medical Council · doi:10.21518/2079-701x-2021-20-75-82 · Cited by 3
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Tumor Infiltrating Lymphocytes in Breast Cancer: Implementation of a New Histopathological Biomarker
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Saavedra, C., Vallejo, A., Longo, F., Domingo, J. J. S., Fernández-Abad, M., Gión, M., López-Miranda, E., Martínez-Jáñez, N., Guerra, E. M., Chamorro, J., et al. (2023) · Cancers · doi:10.3390/cancers15072000 · Cited by 3
Potential Role of Immunotherapy for Advanced Breast Cancer
de Mello, R. A., Amaral, G. A., Tajima, C. C., et al. (2021) · Immunotherapy · doi:10.2217/imt-2021-0037 · Cited by 3
Luminal Metastatic Breast Cancer: Current Concepts and Future Approaches
Ettl, J. (2021) · Breast Care · doi:10.1159/000515804 · Cited by 3
Masuda, N., Yoshinami, T., Ikeda, M., Mizutani, M., Yamaguchi, M., Komoike, Y., Takashima, T., Yoshidome, K., Tsurutani, J., Iwamoto, M., et al. (2021) · Cancers · doi:10.3390/cancers13174399 · Cited by 3
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Doğan, İ., Aksoy, S., Çakar, B., Başaran, G., Erçelep, Ö., Mandel, N. M., Korkmaz, T., Gökmen, E., Sener, B. C., Aydıner, A., et al. (2023) · Cancers · doi:10.3390/cancers15061667 · Cited by 7
Ferraro, G. A., Mattiello, S., Natriello, A., et al. (2024) · Aesthetic Plastic Surgery · doi:10.1007/s00266-024-04034-w · Cited by 2
“However, over the years, a multidisciplinary treatment approach (i.e. hormone therapy, chemotherapy, surgery, and radiotherapy) brought higher survival rates of BC [2, 3].”
Schmidt, M., Hesse, T., Hoffmann, O., et al. (2025) · Cancers · doi:10.3390/cancers17030457 · Cited by 2
“Eribulin, a halichondrin-class microtubule-dynamics inhibitor commonly used to treat breast cancer [1,2], is a preferred treatment for patients with advanced breast cancer after treatment with anthracyclines and taxanes [3,4].”
Nakayama, S., Iwamoto, T., Araki, K., et al. (2025) · Breast Cancer · doi:10.1007/s12282-025-01680-z · Cited by 2
Ring, A. E., Sutherland, S., Harper-Wynne, C. L., Owen, J., Sanglier, T., & Velikova, G. (2025) · Breast Cancer Research and Treatment · doi:10.1007/s10549-025-07708-4 · Cited by 2
“Since the publication of the original first line pertuzumab studies, new therapies have been developed for the treatment of advanced HER2-positive breast cancer [3].”
Decker, T. W., Brucker, C. V. M., Engel, A., Fasching, P. A., Göhler, T., Jackisch, C., Janßen, J., Köhler, A., Lüdtke-Heckenkamp, K., Lüftner, D., et al. (2025) · ESMO Open · doi:10.1016/j.esmoop.2025.105105 · Cited by 4
Valer, J. A., Deber, A., Wits, M., Pimenta-Lopes, C., Goumans, M., Rosa, J. L., Sánchez‐Duffhues, G., & Ventura, F. (2023) · eLife · doi:10.7554/elife.91779.4 · Cited by 4
Bando, H., Ueda, A., Terata, K., et al. (2025) · Breast Cancer · doi:10.1007/s12282-025-01744-0 · Cited by 2
“In addition, it is internationally recognized that electronic monitoring of PROs and real-time data collection has great utility for facilitating communication with patients and care teams, decision-making, and early intervention, all of which are aimed at improving patient overall QOL [14, 16, 32].”
Schettini, F., Nucera, S., Grazia, G. D., Giudici, F., Strina, C., Milani, M., Tancredi, R. J., Conte, B., Criscitiello, C., Giuliano, M., et al. (2025) · JNCI Cancer Spectrum · doi:10.1093/jncics/pkaf083 · Cited by 2
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Korantzis, I., Koumarianou, A., Rapti, V., Timotheadou, E. T., Christodoulou, C., Tryfonopoulos, D. J., Karageorgopoulou, S., Boukovinas, I., Zagouri, F., Nikolaidi, A., et al. (2025) · BMC Cancer · doi:10.1186/s12885-025-14791-9 · Cited by 2
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Self-citationPaiano, L., Adam, R. A., & Golse, N. (2025) · Surgical Oncology · doi:10.1016/j.suronc.2025.102330 · Cited by 3
Ding, L., Shang, Y., Zhang, Z., et al. (2025) · Scientific Reports · doi:10.1038/s41598-025-29411-6 · Cited by 2
Bülbül, B., Ucun, B., Cangür, C., Yeğen, İ. T., Eren, O. Ö., Yılmaz, C., Gül, G., Erdoğan, A. P., Hafızoğlu, E. Ş., Gökmen, E., et al. (2025) · Current Oncology · doi:10.3390/curroncol32120709 · Cited by 2
“Our results strongly reinforce current guideline recommendations to implement CDK4/6 inhibitor combinations in first-line settings to maximise patient benefit [3].”
Mazzoli, G., Provenzano, L., Dieci, M. V., Curigliano, G., Giuliano, M., Botticelli, A., Lambertini, M., Rizzo, G., Pedersini, R., Sirico, M., et al. (2025) · The Breast · doi:10.1016/j.breast.2026.104692 · Cited by 3
Self-citationBaek, S. Y., Hong, M., Lee, S. S., et al. (2026) · Frontiers in Oncology · doi:10.3389/fonc.2025.1709317 · Cited by 2
Self-citationBreast cancer liver metastases and the impact of receptor expression on survival
Hansson, E., Sundén, M., Wadsten, C., Rask, G., Andersson, A., Sund, M., & Hemmingsson, O. (2026) · Clinical & Experimental Metastasis · doi:10.1007/s10585-025-10387-6 · Cited by 2
Zhu, Y., Zheng, S., Shao, Y., Zhou, J., Gu, X., Shen, L., Li, X., Liu, W., Xue, W., Lu, H., et al. (2026) · Nature Communications · doi:10.1038/s41467-026-70204-w · Cited by 5
Anderson, J., Lawton, S., Thackray, K. E., & Kipps, E. (2026) · British Journal of Cancer · doi:10.1038/s41416-026-03396-z · Cited by 2
“This variation underscores the need to consider real-world factors, such as patient comorbidities and treatment history, when assessing the generalisability of clinical trial data, and informs more effective treatment approaches for diverse patient populations in routine practice.”
Rugo, H. S., Curigliano, G., Cescon, D. W., Penault-Llorca, F. M., Harbeck, N., Im, S., Park, Y. H., Barrios, C., Modi, S., Tolaney, S. M., et al. (2026) · The Breast · doi:10.1016/j.breast.2026.104831 · Cited by 2
“Elements in pink indicate updates made in ABC6/7 [4] vs ABC5 (ESO-ESMO) [15] guidelines.”
InfluentialSelf-citationHijacking the bone niche: mechanistic insights into bone metastasis in breast cancer
Wu, J. I. A. H. U. I., Deng, M., Ye, F., Deng, W., Wu, Z. Z., Zheng, X. B., Song, C., Zou, Y., & Tang, H. (2026) · Bone Research · doi:10.1038/s41413-026-00547-z · Cited by 3
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Metastases after mastectomy for ductal carcinoma in situ of the male breast; A case report
Pant, V. P., Dallakoti, N., Pokhrel, N., et al. (2022) · Annals of Medicine and Surgery · doi:10.1016/j.amsu.2022.103451 · Cited by 2
“As chemotherapy is reserved for visceral crisis [16], and our patient had only bone metastasis with no evidence of visceral crisis, it was not prescribed.”
BackgroundZhang, L. (2022) · Thoracic Cancer · doi:10.1111/1759-7714.14399 · Cited by 2
“However, drug resistance is a major obstacle that limits the success of endocrine therapy in breast cancer.(5) Recent studies have demonstrated that combining endocrine therapy with drugs that target resistance mechanisms can delay the development of endocrine therapeutic resistance.”
BackgroundHormone Receptor and HER2 Status Switch in Non-pCR Breast Cancer Specimens after Neoadjuvant Therapy
Dimpfl, M., Mayr, D. C., Schmoeckel, E., Degenhardt, T., Eggersmann, T. K., Harbeck, N., & Wuerstlein, R. (2022) · Breast Care · doi:10.1159/000524698 · Cited by 2
Self-citationA Novel Surrogate Nomogram Capable of Predicting OncotypeDX Recurrence Score©
Davey, M. G., Jalali, A., Ryan, É. J., et al. (2022) · Journal of Personalized Medicine · doi:10.3390/jpm12071117 · Cited by 2
Kuba, S., Maeda, S., Minami, S., Moriuchi, H., Tanaka, A., Akashi, M., Morita, M., Sakimura, C., Baba, M., Otsubo, R., et al. (2022) · Scientific Reports · doi:10.1038/s41598-022-18069-z · Cited by 2
Hasler-Strub, U., Mueller, A., Li, Q., et al. (2022) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2022.09.001 · Cited by 2
“Palliative treatment aims to maintain or improve quality of life by reducing disease symptoms while inflicting minimal toxicities [4], particularly in the older population.”
Wu, B., Sun, C. M., Sun, X., et al. (2022) · Journal of Clinical Pharmacy and Therapeutics · doi:10.1111/jcpt.13776 · Cited by 2
Patnaik, A., Hamilton, E. P., Xing, Y., Rasco, D. W., Smith, L. S., Lee, Y.-L., Fang, S., Wei, J., & Hui, A. (2022) · Cancers · doi:10.3390/cancers14204996 · Cited by 3
Senkpeil, R. R., Olson, J. S., Fortune, E. E., & Zaleta, A. K. (2022) · Journal of Patient Experience · doi:10.1177/23743735221134733 · Cited by 2
Pyrotinib for Elderly Patients with Advanced HER2-Positive Breast Cancer
Li, Y., Ma, X., Zhao, Z., et al. (2022) · Breast Cancer Targets and Therapy · doi:10.2147/bctt.s383272 · Cited by 2
Valente, A., Tavares, N., Caeiro, C., et al. (2023) · Cureus · doi:10.7759/cureus.34893 · Cited by 2
“In other cases, the surgery must be considered for the benefit of the quality of life, after a shared decision with the patient [12].”
BackgroundLacaze, J., Chira, C., Glemarec, G., et al. (2023) · Breast Cancer Research and Treatment · doi:10.1007/s10549-023-06880-9 · Cited by 2
Heinolainen, K., Saarinen, S., Vertuani, S., Ellonen, A., Karlsson, A., Utriainen, M., Carlqvist, P., Mandelin, J., & Holm, B. (2023) · Journal of Cancer Research and Clinical Oncology · doi:10.1007/s00432-023-04723-0 · Cited by 2
Bruckner, H. W., Chawla, S. P., Omelchenko, N., Brigham, D. A., & Gordon, E. M. (2023) · Frontiers in Molecular Medicine · doi:10.3389/fmmed.2023.1105680 · Cited by 2
“Recent evidence supports a positive role of hormone therapy in ER + HER2+ metastatic breast cancer (Cardoso, 2020).”
BackgroundHalim, F., Azhar, Y., Suwarman, S., Wahjoepramono, E. J., & Hernowo, B. S. (2023) · Diagnostics · doi:10.3390/diagnostics13111838 · Cited by 2
Trastuzumab deruxtecan for breast cancer: do patients experience a comprehensive benefit?
Mosele, F., & Maïo, M. D. (2023) · Annals of Oncology · doi:10.1016/j.annonc.2023.05.011 · Cited by 2
Expression Value of Rab10 in Breast Cancer
Zhuo, J., Zhao, Y., Han, J., Li, H., Hao, R., Yang, Y., Dai, L., Sheng, A., Xiao-hong, Y., & Liu, W. (2023) · Clinical and Experimental Obstetrics & Gynecology · doi:10.31083/j.ceog5008169 · Cited by 2
“According to international consensus guidelines, the current treatment for BC mainly includes chemotherapy, radiotherapy, targeted therapy, immunotherapy, and endocrine therapy before and after surgery [3].”
Jaeger, B. A. S., Krawczyk, N., Japp, A. S., Honisch, E., Köhrer, K., Scheuring, S., Petzsch, P., Neubauer, H. J., Volkmer, A. K., Esposito, I., et al. (2023) · Geburtshilfe und Frauenheilkunde · doi:10.1055/a-2150-9440 · Cited by 2
Wei, X., Zhang, H., Tu, Y.-H., et al. (2023) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2023.12324 · Cited by 2
“Such advanced stages are often synonymous with a poor prognosis, where systemic therapy is the conventional treatment modality (2).”
BackgroundÇiçin, İ., Karadurmuş, N., Bilici, A. E., Bahsi, T., Şendur, M. A. N., Demırcı, U., Göksu, S. S., Er, O., Bişgin, A., Saglam, O. F. O., et al. (2023) · Future Oncology · doi:10.2217/fon-2023-0518 · Cited by 3
Gilchrist, J. (2023) · Seminars in Oncology Nursing · doi:10.1016/j.soncn.2023.151547 · Cited by 4
Treatment and Management of the Clinical Manifestations of Advanced Breast Cancer
Shewbridge, A., Meade, E., & Dowling, M. (2023) · Seminars in Oncology Nursing · doi:10.1016/j.soncn.2023.151549 · Cited by 2
Zhang, T., Liu, J., Wang, M., Liu, X., Qu, J., & Zhang, H. (2024) · Frontiers in Oncology · doi:10.3389/fonc.2023.1288909 · Cited by 2
Hong, J., Chen, T., Ouyang, L., Du, N., Li, A., Zhongqi, Z., Zhang, H., Xia, Z., & Meng, J. (2024) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1080/14737167.2024.2330542 · Cited by 2
“Given that ABC remains incurable, treatment goals should encompass not only improving survival but also maintaining the quality of life and palliation of symptoms [6,7].”
BackgroundPerspectives for the clinical application of ctDNA analysis to breast cancer drug therapy
Yoshinami, T. (2024) · Breast Cancer · doi:10.1007/s12282-024-01571-9 · Cited by 2
“When no mutation in ESR1 , PIK3CA , AKT1 , or PTEN is detected, everolimus can be selected as therapy after CDK4/6 inhibitor plus AI [37].”
Püsküllüoğlu, M., Grela-Wojewoda, A., Ambicka, A., et al. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1217495 · Cited by 2
Cerebral Metastases in Breast Cancer Patients: a Narrative Review
Müller, C., Schmidt, G., Solomayer, E., Popp, I., Grosu, A., Juhasz‐Böss, I., Jung, L., & Huwer, S. I. (2024) · Current Breast Cancer Reports · doi:10.1007/s12609-024-00558-x · Cited by 2
Kubeczko, M., Polakiewicz-Gilowska, A., Swiderska, K., et al. (2024) · Frontiers in Oncology · doi:10.3389/fonc.2024.1408664 · Cited by 2
“Endocrine treatment in combination with cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) is the standard of care in fi rst-line and second-line treatment of advanced hormone-receptor positive human epidermal growth factor receptor 2 (HER-2) negative advanced breast cancer (1, 2).”
BackgroundInfluentialIdentifying drivers of first-line HR+/HER2− metastatic breast cancer treatment choices
Brufsky, A., Maculaitis, M. C., Kopenhafer, L., Olsen, P., Kurosky, S. K., Arruda, L. S., Heck, W. D., & Cha-Silva, A. S. (2024) · Future Oncology · doi:10.1080/14796694.2024.2350294 · Cited by 2
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Wang, X., Bao, S., Jiang, M., et al. (2024) · Clinical & Translational Oncology · doi:10.1007/s12094-024-03547-9 · Cited by 2
“H , I Transwell assay indicated that shKMT2C inhibited the invasion of breast cancer cells receptor status for helping choose the right treatment strategy [26, 27].”
Yamamoto, M., Shibata, M., Tanaka, A., et al. (2024) · Surgery Today · doi:10.1007/s00595-024-02893-z · Cited by 2
Kubeczko, M., Gabryś, D., Krzywon, A., et al. (2024) · British Journal of Radiology · doi:10.1093/bjr/tqae138 · Cited by 2
Liao, Y., Tan, Y., Li, Y., Ma, F., Wang, J., Zhang, P., Li, Q., Li, Q., Luo, Y., Lan, B., et al. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e38147 · Cited by 2
Self-citationWu, J., Pan, D., Zou, L., et al. (2024) · Current Cancer Drug Targets · doi:10.2174/0115680096303785240822155217 · Cited by 2
Huang, J., Zhen, W., Ma, X., et al. (2024) · Journal of Clinical Biochemistry and Nutrition · doi:10.3164/jcbn.23-131 · Cited by 2
Almekinders, C. A., Lin, L., Beijnen, J. H., Sonke, G. S., Huitema, A. D. R., & Dezentjé, V. O. (2024) · Breast Cancer Research and Treatment · doi:10.1007/s10549-024-07542-0 · Cited by 3
Kubeczko, M., Gabryś, D., Rembak-Szynkiewicz, J., Gräupner, D., Polakiewicz-Gilowska, A., & Jarząb, M. (2024) · Radiotherapy and Oncology · doi:10.1016/j.radonc.2024.110639 · Cited by 2
Prognostic relevance of CD163+ immune cells in patients with metastatic breast cancer
Lindberg, I., Saleh, A., Tutzauer, J., et al. (2025) · Cancer Immunology Immunotherapy · doi:10.1007/s00262-024-03892-2 · Cited by 2
Kruss, G., Dinh, T. T. H., van Huizen, P., Yeganeh, L., Mahony, J., Morphet, J., Brand, G., Crawford-Williams, F. M., & Cook, O. (2025) · Journal of Clinical Nursing · doi:10.1111/jocn.17609 · Cited by 2
“With continued advancements in knowledge about BC and the development and release of new treatments (Cardoso et al. 2020; Gennari et al. 2021), these newly developed tools will require frequent updates to remain relevant, for example, items relating to lines of treatment for BC will require regular…”
Zeng, H.-A., Lv, H., Zhang, M., et al. (2025) · Journal of Cancer Research and Clinical Oncology · doi:10.1007/s00432-025-06133-w · Cited by 2
“Subsequent disease progression may warrant che - motherapy options including eribulin, capecitabine, gemcitabine, vinorelbine, other taxanes, platinum-based drugs, or docetaxel rechallenge (Jiang et al. 2022; Lorusso et al. 2020; Cardoso et al. 2020; Kaufman et al. 2015 ; Wang et al. 2022 ).”
Ateş, Y. Ü., Aydos, U., Balcı, E., Ateş, S. G., & Atay, L. (2025) · Clinical and translational imaging · doi:10.1007/s40336-025-00690-3 · Cited by 4
A Pragmatic Grouping Model for Bone-Only De Novo Metastatic Breast Cancer (MetS Protocol MF22-03)
Göktepe, B., Demirors, B., Şenol, K., Özbaş, S., Sezgın, E., Lucci, A., & Soran, A. (2025) · Cancers · doi:10.3390/cancers17122033 · Cited by 2
“Although the definition remains debated, the most commonly accepted criterion is the presence of five or fewer metastatic lesions, regardless of the number of involved organs [22].”
Ricciardi, G. R. R., Russo, A., Sanò, M. V., et al. (2025) · Cancers · doi:10.3390/cancers17132069 · Cited by 2
“International guidelines recommend that elderly women with metastatic breast cancer be treated as young patients, reserving a different approach only for non-fit older patients [14,15].”
Cardoso, F., Wuerstlein, R., Aruga, T., et al. (2025) · The Breast Journal · doi:10.1155/tbj/2461234 · Cited by 2
“While international guidelines highlight the importance of shared decision-making in mBC [23], its uptake is low in clinical practice [41, 69].”
Self-citationAlmeida, C. F., Correia‐da‐Silva, G., Ribeiro, A. P., Teixeira, N. A. A., & Amaral, C. (2025) · Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids · doi:10.1016/j.bbalip.2025.159658 · Cited by 3
Mistry, T., Sengupta, S., Kumar, R., et al. (2025) · The Pharmacogenomics Journal · doi:10.1038/s41397-025-00380-3 · Cited by 2
“FDG-PET scan was only done in patients with high chance of micro-metastasis [19].”
Oikonomidou, O., Beresford, M. J., Galve-Calvo, E., Woeckel, A., Parikh, R. C., Hitchens, A., Chen, C., Doan, J. F., Li, B. C., Ansquer, V. D., et al. (2025) · Breast Cancer Research and Treatment · doi:10.1007/s10549-025-07707-5 · Cited by 2
“…in the European Society for Medical Oncology (ESMO) guidelines on treatment for HR+/HER2− ABC, large-scale real-world assessments of characteristics among patients with HR+/ HER2− ABC, palbociclib treatment patterns, and associated clinical outcomes in Europe are limited [7, 14, 15].”
Rouge, T. D. L. M., Frenel, J., Cropet, C., Borcoman, É., Hervieu, A., Emile, G., Augereau, P., Charafe‐Jauffret, E., Legrand, F., Dassé, E., et al. (2025) · The Breast · doi:10.1016/j.breast.2025.104549 · Cited by 2
“Indeed, advanced BC were not viewed as immunologically active at first, given the limited efficacy of anti-PD-1/PD-L1 monotherapy in these tumors [12 – 14].”
Jouines, C., Monaco, P. L., Gaucherot, A., et al. (2025) · Breast Cancer Research · doi:10.1186/s13058-025-02163-x · Cited by 2
“The efficacy of these treatments is limited, and relapses are common due to the metastatic nature of TNBC. Patients harbouring TNBC have a 5-year survival rate ranging from 20 to 50%, depending on the metastatic site, highlighting the inter-tumor heterogeneity of TNBC [2].”
Hayama, S., Nakamura, R., Miyaki, T., et al. (2021) · Breast Care · doi:10.1159/000515729 · Cited by 2
Kolyadina, I. V. (2021) · Tumors of female reproductive system · doi:10.17650/1994-4098-2021-17-3-59-68 · Cited by 2
Piemontese, A., Galvain, T., Swindells, L., et al. (2022) · PLoS ONE · doi:10.1371/journal.pone.0268708 · Cited by 2
“Axillary lymph node dissection (ALND) is also further recommended by ESMO guidelines in patients with (micro)metastatic spread [6, 7].”
BackgroundHolm, J., Farahani, Z. A., Gerke, O., et al. (2020) · Diagnostics · doi:10.3390/diagnostics10121021 · Cited by 2
“Recent international guidelines recommend minimal imaging work-up for metastatic breast cancer to include imaging of the chest and abdomen, preferably with a computed tomography (CT) scan, and of bone [1].”
BackgroundT-DM1 for advanced breast cancer after multi-anti-HER2-target therapy: a case report
Sun, L., Gan, L., & Wang, T. (2021) · Translational Breast Cancer Research · doi:10.21037/tbcr-21-70 · Cited by 2
Orlandi, A., D’Archi, S., Garufi, G., et al. (2021) · Minerva Surgery · doi:10.23736/s2724-5691.21.09007-9 · Cited by 2
Updated Austrian treatment algorithm in HER2+ metastatic breast cancer
Bartsch, R., Gampenrieder, S. P., Rinnerthaler, G., Petru, E., Egle, D., Petzer, A. L., Balić, M., Pluschnig, U., Sliwa, T., & Singer, C. F. (2022) · Wiener klinische Wochenschrift · doi:10.1007/s00508-021-01987-9 · Cited by 2
Chandrakanth, M. (2022) · International Journal of Molecular and Immuno Oncology · doi:10.25259/ijmio_8_2022 · Cited by 2
Shatkovskaya, O., Kaidarova, D., Dushimova, Z., Sagi, M., & Абдрахманов, Р. (2021) · Oncologia i radiologia Kazakhstana · doi:10.52532/2663-4864-2021-4-62-16-23 · Cited by 2
Austrian treatment algorithms in HER2-positive metastatic breast cancer: a 2022 update
Rinnerthaler, G., Singer, C. F., Petru, E., Egle, D., Petzer, A. L., Pluschnig, U., Gampenrieder, S. P., Pfeiler, G., Gnant, M., Grünberger, B., et al. (2022) · Wiener klinische Wochenschrift · doi:10.1007/s00508-022-02082-3 · Cited by 2
Krajnak, S., Trier, J. P., Heinzmann, P. F., Anić, K., Heimes, A.-S., Loewe, A., Schmidt, M., Battista, M. J., Hasenburg, A., & Brenner, W. (2022) · EXCLI journal · doi:10.17179/excli2022-5064 · Cited by 2
Metadata
- Authors
- Cardoso, F., Paluch-Shimon, S., Senkus, E., Curigliano, G., Aapro, M. S., André, F., Barrios, C. H., Bergh, J., Bhattacharyya, G. S., Biganzoli, L., Boyle, F., Cardoso, M.-J., Carey, L. A., Cortés, J., El Saghir, N. S., Elzayat, M., Eniu, A., Fallowfield, L., Francis, P. A., Gelmon, K., Gligorov, J., Haidinger, R., Harbeck, N., Hu, X., Kaufman, B., Kaur, R., Kiely, B. E., Kim, S.-B., Lin, N. U., Mertz, S. A., Neciosup, S., Offersen, B. V., Ohno, S., Pagani, O., Prat, A., Penault-Llorca, F., Rugo, H. S., Sledge, G. W., Thomssen, C., Vorobiof, D. A., Wiseman, T., Xu, B., Norton, L., Costa, A., & Winer, E. P.
- Affiliations
- Champalimaud Foundation (PT)
- Gdańsk Medical University (PL)
- University of Milan (IT)
- Clinique de Genolier (CH)
- Institut Gustave Roussy (FR)
- Latin American Cooperative Oncology Group (LACOG) (BR)
- Karolinska University Hospital (SE)
- Ospedale di Prato Santo Stefano (IT)
- Royal North Shore Hospital (AU)
- University of North Carolina at Chapel Hill (US)
- Vall d'Hebron Institute of Oncology (ES)
- Europa Donna (IT)
- Hôpital Riviera-Chablais (CH)
- Brighton and Sussex Medical School (GB)
- Peter MacCallum Cancer Centre (AU)
- BC Cancer Agency (CA)
- Sorbonne Université (FR)
- Ludwig-Maximilians-Universität München (DE)
- Fudan University (CN)
- Sheba Medical Center (IL)
- National Health and Medical Research Council (AU)
- Asan Medical Center (KR)
- Dana-Farber Cancer Institute (US)
- Metastatic Breast Cancer Network (US)
- Instituto Nacional de Enfermedades Neoplásicas (PE)
- Aarhus University Hospital (DK)
- The Cancer Institute Hospital (JP)
- University Hospital of Geneva (CH)
- Hospital Clínic de Barcelona (ES)
- Inserm (FR)
- University of California, San Francisco (US)
- Stanford Medicine (US)
- Martin Luther University Halle-Wittenberg (DE)
- Royal Marsden NHS Foundation Trust (GB)
- Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
- Memorial Sloan Kettering Cancer Center (US)
- European School of Oncology (CH)
- Corresponding author
- Cardoso, F.
- ORCID
- Cardoso, F.
- Senkus, E.
- Curigliano, G.
- Aapro, M.S.
- André, F.
- Bergh, J.
- Biganzoli, L.
- Boyle, F.
- Cardoso, M.-J.
- Carey, L.A.
- Cortés, J.
- Eniu, A.
- Fallowfield, L.
- Francis, P.A.
- Gelmon, K.
- Gligorov, J.
- Haidinger, R.
- Harbeck, N.
- Hu, X.
- Kaufman, B.
- Kiely, B.E.
- Lin, N.U.
- Neciosup, S.
- Ohno, S.
- Pagani, O.
- Prat, A.
- Penault-Llorca, F.
- Rugo, H.S.
- Sledge, G.W.
- Thomssen, C.
- Wiseman, T.
- Xu, B.
- Norton, L.
- Costa, A.
- Winer, E.P.
- Venue
- Annals of Oncology
- Publisher
- Elsevier BV
- Published
- 2020-12
- Volume
- 31
- Issue
- 12
- Pages
- 1623-1649
- ISSN
- 0923-7534 (ISSN-L)
- PMC
- PMC7510449
- OpenAlex
- W4206666777
- Cited by
- 1,369
- References
- 147
- Citations by year
- 2026: 151 · 2025: 182 · 2024: 238 · 2023: 276 · 2022: 293 · 2021: 210 · 2020: 18
- FWCI
- 68.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Annals of Oncology (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- Cold Spring Harbor Laboratory Institutional Repository (Cold Spring Harbor Laboratory) (submittedVersion)
- HAL (submittedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- Minerva Access (University of Melbourne) (submittedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by)
- The Sydney eScholarship Repository (The University of Sydney) (submittedVersion)
- Funders
- ESMO
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
- Health Sciences › Medicine › Oncology › Advanced Breast Cancer Therapies
- Health Sciences › Medicine › Oncology › HER2/EGFR in Cancer Research
- Keywords
- advanced breast cancer, metastatic breast cancer, locally advanced breast cancer, treatment guidelines, HER2-positive breast cancer, breast cancer subtypes, overall survival
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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