ESO-ESMO International Consensus Guidelines for Advanced ...

ESO-ESMO International Consensus Guidelines for Advanced Breast Cancer ? ABC

ESO-ESMO ABC RECOMMENDATIONS

ABC Global Charter 10 goals for the next 10 years

COMPREHENSIVE NEEDS ASSESSMENT DEFINES MOST URGENT AND ACTIONABLE GOALS Done with (almost) all different stakeholders involved in ABC

1 HELP PATIENTS WITH ABC LIVE LONGER BY DOUBLING ABC MEDIAN OVERALL SURVIVAL BY 2025

2 ENHANCE OUR UNDERSTANDING ABOUT ABC BY INCREASING THE COLLECTION OF HIGH QUALITY DATA

3 IMPROVE THE QUALITY OF LIFE (QOL) OF PATIENTS WITH ABC

4 ENSURE THAT ALL PATIENTS WITH ABC RECEIVE THE BEST POSSIBLE TREATMENT AND CARE BY INCREASING AVAILABILITY OF ACCESS TO CARE FROM A MULTIDISCIPLINARY TEAM

5 IMPROVE COMMUNICATION BETWEEN HEALTHCARE PROFESSIONALS (HCP) AND PATIENTS WITH ABC THROUGH THE PROVISION OF COMMUNICATION SKILLS TRAINING FOR HCPS

6 MEET THE INFORMATIONAL NEEDS OF PATIENTS WITH ABC BY USING EASY TO UNDERSTAND, ACCURATE AND UPTO-DATE INFORMATION MATERIALS AND RESOURCES

7 ENSURE THAT PATIENTS WITH ABC ARE MADE AWARE OF AND ARE REFERRED TO NON-CLINICAL SUPPORT SERVICES

8 COUNTERACT THE STIGMA AND ISOLATION ASSOCIATED WITH LIVING WITH ABC BY INCREASING PUBLIC UNDERSTANDING OF THE CONDITION

9 ENSURE THAT PATIENTS WITH ABC HAVE ACCESS TO TREATMENT REGARDLESS OF THEIR ABILITY TO PAY

10

HELP PATIENTS WITH ABC CONTINUE TO WORK BY IMPLEMENTING LEGISLATION THAT PROTECTS THEIR RIGHTS TO WORK AND ENSURE FLEXIBLE AND ACCOMMODATING WORKPLACE ENVIRONMENTS

2

LEVELS OF EVIDENCE GRADING SYSTEM

LEVELS OF EVIDENCE

I

Evidence from at least one large randomized, controlled trial of good methodological

quality (low potential for bias) or meta-analyses of well-conducted randomized trials

without heterogeneity.

II

Small randomized trials or large randomized trials with a suspicion of bias (lower

methodological quality) or meta-analyses of such trials or of trials with demonstrated

heterogeneity.

III

Prospective cohort studies.

IV

Retrospective cohort studies or case?control studies.

V

Studies without control group, case reports, experts' opinions.

GRADES OF RECOMMENDATION

A

Strong evidence for efficacy with a substantial clinical benefit, strongly recommended.

B

Strong or moderate evidence for efficacy but with a limited clinical benefit, generally

recommended.

C

Insufficient evidence for efficacy or benefit does not outweigh the risk or the disadvantages

(adverse events, costs, ...), optional.

D

Moderate evidence against efficacy or for adverse outcome, generally not recommended.

E

Strong evidence against efficacy or for adverse outcome, never recommended.

Adapted by permission from the Infectious Diseases Society of America-United States Public Health Service Grading System; Dykewicz et al, 2001

INTRODUCTION

? All panel members (including the chairs) must vote in all questions

? Members of the panel who have a conflict of interest OR who do not feel comfortable answering the question(e.g. not area of expertise) should vote "abstain"

? There is an additional possible answer for the Precision Medicine statements: "Insufficient data", which should be selected if the panel member believes the existent data is not enough to vote "yes" or "no", highlighting an area where research is needed

? ABC 1-2-3-4 statements that will not be re-voted (not updated or with only minor changes) will be published in the manuscript

GENERAL NOTE

Where the Guidelines state "preferred option" or "standard of care", they assume availability of the agent. All guidelines that are related to a certain treatment depend, obviously, on the availability of that treatment.

It is possible to discuss adaptation of the ABC Guidelines to different environments, but that is a separate project, outside the scope of the main guidelines.

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