Metastatic breast cancers: Prise en charge différentielle en fonction des caractéristiques clinicopathologiques: réflexions d’experts sur les facteurs pronostiques, prédictifs d’efficacité et de décision thérapeutique

Although the treatment of early breast cancer is relatively well-defined, therapeutic options for metastatic breast cancer remains controversial. The published guidelines for the management of metastatic breast cancer mainly aim to draw up a list of available agents and treatments according to menopausal status and hormone receptors (HR). Taking into account all the variables influencing therapeutic decision-making, the purpose of the present study was to find a consensus with respect to patients with metastatic breast cancer. The selected prognostic factors were disease-free duration, visceral metastasis, HR, and possibly LDH. The validated predictive factors of response to treatment were HR and HER2 status. The choice of these predictive factors as well as the disease's level of aggressiveness were the basis for the choice of first-line treatment i.e. chemotherapy (mono- or poly-chemotherapy, concomitant or sequential), hormonotherapy, or chemoendocrine therapy.