2025 Update of the Taiwan Expert Consensus on Hormone Receptor-Positive Metastatic Breast Cancer Management

Area of Science:

• Oncology
• Endocrinology
• Clinical Practice Guidelines

Background:

• Hormone receptor-positive metastatic breast cancer presents significant clinical challenges due to sequential endocrine resistance.
• Recent advancements in biomarkers, endocrine therapies, and antibody-drug conjugates have increased treatment complexity.

Purpose of the Study:

• To update the 2023 Taiwan Breast Cancer Society (TBCS) expert consensus on managing metastatic breast cancer.
• To provide evidence-based recommendations for treatment selection and sequencing in Taiwan.

Main Methods:

• A multidisciplinary panel conducted a systematic literature review.
• A modified Delphi process was used for iterative discussions and consensus building.
• Recommendations were updated based on practice-changing evidence, maintaining continuity with the previous consensus.

Main Results:

• Updated recommendations were formulated with assigned levels of evidence and strengths of recommendation.
• Key updates were integrated into practical treatment algorithms tailored for Taiwan.
• The consensus addresses risk evaluation, biomarker testing, and treatment selection for various lines of therapy.

Conclusions:

• The updated TBCS consensus offers a framework for integrating emerging therapies into clinical practice.
• It supports real-world decision-making for hormone receptor-positive metastatic breast cancer in Taiwan and the Asia-Pacific region.
• The guidelines facilitate evidence-based management of complex treatment scenarios.