Olubukola Ayodele, Co-Founder at Cancer Conversations CIC, Co-Convenor (Co-Chair) at London Global Cancer Week, shared on LinkedIn:
“Oct 13th is dedicated to metastatic breast cancer.
In September 2018, I spent a few days in Lisbon with Prof Fatima Cardoso and it changed my entire view of advanced breast cancer.
ABC4 was the international consensus guideline at the time, and one of the slides I photographed was about the goals of treating advanced breast cancer.
Improve survival. Delay progression. Prolong response. Palliate symptoms. Maintain quality of life.
Then there was the ultimate goal: ‘Transform advanced breast cancer into a chronic disease.’
Last month, ABC8, the 8th International Consensus Guidelines for the management of advanced breast cancer, was released, and naturally I went straight to the new and updated recommendations.
For a breast oncologist, these guidelines are a bit like the holy grail of advanced breast cancer management.
What I love about ABC is that it goes beyond telling us which drug to give and when.
It tries to address the complexity of looking after someone with a disease that, for most, is not curable, where treatment may continue for years and every decision has consequences for what comes next.
Reading ABC8 also gives you a sense of just how much advanced breast cancer has changed since that photo was taken.
We have new drug classes, new targets and many more treatment options.
We understand resistance differently.
Treatment sequencing is becoming more complex.
Survival has improved considerably in some subtypes, although those improvements remain dependent on access to the best diagnostics, treatments and multidisciplinary care.
The guidelines have evolved in other ways too.
ABC8 talks about survivorship in advanced breast cancer. Working while living with cancer. Exercise. Quality of life. Caregivers. Patient preferences. Inequalities in access to care.
These are not peripheral to treating advanced breast cancer. They are part of it.
It’s been eight years since I took that photo and going back to that 2018 slide after reading ABC8 was quite provoking.
Have we transformed advanced breast cancer into a chronic disease?
Definitely, not for everyone, however, for some of our patients, what we can offer today would have been difficult to imagine when ABC4 was published.
There is a lot in ABC8 that I think is worth discussing, so over the next few weeks (probably after ESMO 2026), I will be sharing some of the new and updated recommendations and, importantly, what they mean in clinical practice.
I’ll be starting with the newly updated definitions of endocrine sensitivity, resistance and insensitivity.
Follow me so you don’t miss the ABC8 updates.”
Goals of the Treatment in ABC
Balancing treatment efficacy and toxicity is the main objective․
Goals of treatment:
- Improve survival (very few agents achieve it!)
- Delay disease progression
- Prolong duration of response
- Palliate symptoms
- Improve or maintain quality of life
- Transform into a chronic disease
You can also read: Can Maintenance HER2 Therapy Be Stopped? Global Survey Reveals Clinical Equipoise in Long-Term Responders
