指南标题：Use of Biomarkers to Guide Decisions on Systemic Therapy for Women With Metastatic Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline

发布机构：美国临床肿瘤学会(ASCO, American Society of Clinical Oncology)

指南发表：J Clin Oncol. 2015 Jul 20.

临床问题2

对于已获知激素受体和HER2状态的转移性乳腺癌女性患者，有哪些已被证实的额外肿瘤标记物可在开始系统治疗或指导选择新的系统治疗方案时具有临床效用？

Clinical Question 2

For women with metastatic breast cancer and with known endocrine receptor and HER2 status, which additional tumor markers have demonstrated clinicalutility to initiate systemic therapy or direct selection of a new systemic therapy regimen?

指南推荐2

转移性乳腺癌开始或选择系统治疗的临床决策应受ER、PR及HER2状态结合临床评估、判断及患者治疗目标的指导。目前，尚无证据表明仅根据额外生物标记检测结果制定治疗决策能改善预后；因此对转移性乳腺癌开始或选择治疗的决定应仅依据ER、PR及HER2状态及特定的临床情况。（来源：循证证据。证据级别：低。推荐等级：中等。）

Recommendation 2

Decisions concerning the initiation of systemic therapy or selection of systemic therapy for metastatic breast cancer should be guided by ER, PR, and HER2 status, in conjunction with clinical evaluation, judgment, and the patient’s goals for care. Presently, there is no evidence that therapy decisions based solely on additional biomarker results improve health outcomes; thus, decisions about initiating or selecting therapy for metastatic breast cancer should be based solely on ER,PR, and HER2 status and the specific clinical scenario. (Type: evidence based. Evidence quality: low. Strength of recommendation: moderate.)

临床解读

专家共识支持应用ER、PR及HER2状态指导临床实践，正如最近更新的ASCO指南所概述的有关HER2及ER、PR检测的报告。除临床试验外，不推荐检测额外的生物标记物应用于临床。

Clinical Interpretation

The consensus of the expert Panel supports the use of ER, PR, and HER2 to guide practice, as outlined in the recent updated ASCO guideline on HER2 testing and on ER and PR testing. No additional biomarkers for clinical use are recommended outside of a clinical trial.