Background: The standard treatment of hormone receptor positive, HER2 negative early breast cancer (BC) is surgery followed by adjuvant systemic therapy either with endocrine therapy alone or with the addition of chemotherapy followed by endocrine therapy. Adjuvant systemic therapy reduces the risk of recurrence and death from BC. Whether an individual patient will benefit from adjuvant chemotherapy is an important clinical decision. Decisions that rely solely on clinical-pathological factors can often lead to overtreatment. Multigene signatures represent an important progress in optimal selection of high risk patients that might benefit from the addition of chemotherapy to adjuvant endocrine therapy. Conclusions: Several signatures are already commercially available and also accepted by international guidelines. Oncotype DX and MammaPrint have been most extensively validated and supported by level IA evidence.

Chemoimmunotherapy (CT/IO) with immune checkpoint inhibitors has recently become the standard of care for extensive-stage small cell lung cancer (ES-SCLC). Given the uncertain role of consolidation thoracic radiotherapy (cTRT) in this setting, we conducted a real-world study to evaluate the efficacy and safety of cTRT in ES-SCLC patients receiving first-line CT/IO. We performed a retrospective analysis of ES-SCLC patients treated with first-line CT/IO in Slovenia from December 2019 to June 2024. Patient characteristics, treatment patterns, survival outcomes, and adverse events were analyzed, with subgroup comparisons based on cTRT administration. Among 208 patients (median age: 66 years), median overall survival was 12.1 months (95% CI: 10.6–13.7). cTRT was administered to 46 patients (22.1%), who had fewer metastases. cTRT was associated with improved OS (17.0 vs. 10.8 months; p < 0.001) and was an independent OS predictor (HR = 0.58, p = 0.035). Grade ≥ 3 adverse events were similar (26.1% vs. 21.3%), though pneumonitis occurred more frequently with cTRT (6.5% vs. 0%, p = 0.001). cTRT may improve survival in ES-SCLC patients treated with CT/IO, with no significant increase in toxicity apart from pneumonitis. Further prospective studies are needed.

Background: Pregnancy associated breast cancer is a rare disease. It presents a unique entity of breast cancer with aggressive phenotype. The main aim was to evaluate how the international guidelines were followed in daily practice. Patients and methods: Data concerning patients’ and tumours’ characteristics, management, delivery and maternal outcome were recorded from institutional electronic database. In this paper a case series of pregnant breast cancer patients treated at single tertiary institution between 2007 and 2019 are presented and the key recommendations on managing such patients are summarized. Results: Fourteen patients met the search criteria. The majority of tumours were high grade, triple negative or HER2 positive, two patients were de novo metastatic. Treatment plan was made for each patient by multidisciplinary team. Eight patients were treated with systemic chemotherapy with no excess toxicity or severe maternal/fetal adverse effects. In all but two patients, delivery was on term and without major complications. Only one event, which was not in whole accordance with international guidelines, was identified. It was the use of blue dye in one patient. Conclusions: Women with pregnancy associated breast cancer should be managed like non-pregnant breast cancer patients and should expect a similar outcome, without causing harm to the unborn child. To achieve a good outcome in pregnancy associated breast cancer, a multidisciplinary approach is mandatory.

Background/Objectives: The prevalence of breast cancer (BC) is significant globally. The malignancy itself and the related treatments have a considerable impact on patients’ overall well-being. The adoption of e-health solutions for patients is increasing rapidly worldwide, since these innovative tools hold significant potential to positively impact the mental health and quality of life (QoL) of BC patients. However, their overall impact is still being explored, and further understanding and analysis are required. This review paper aims to present, quantify, and summarize the cumulative available randomized evidence on the state of the art of supportive interventions delivered via e-health applications for patients’ mental health and QoL before, during, and after BC treatment. Methods: A systematic review was conducted following the PRISMA guidelines in the Scopus and PubMed databases on 7 November 2024 to identify studies that utilized internet-based interventions in BC patients. The inclusion criteria were as follows: adult men and women (aged > 18 years) diagnosed with breast cancer (BC) who received patient-directed e-health interventions, compared to standard care or control interventions. The studies had to focus on outcomes such as quality of life (QoL), anxiety, depression, and distress, and be limited to randomized controlled trials (RCTs). The PRISMA-P guidelines were followed. Risk of bias was assessed using the Cochrane risk-of-bias (RoB) tool for randomized controlled trials. Results: A total of 27 randomized studies, involving 2898 patients, were included in this systematic review. The e-health interventions significantly affected patients’ anxiety (SMD = −0.80; 95% CI: −1.33 to −0.27; p < 0.01; and I² = 94%), depression (SMD = −0.74; 95% CI: −1.40 to −0.09; p = 0.026; and I² = 95%) and QoL (SMD = 0.65; 95% CI: 0.27 to 1.04; p < 0.01; and I² = 90%) but had no significant effect on distress (SMD = −0.78; 95% CI: −1.93 to 0.37; p = 0.184; and I² = 95%). Conclusions: This study showed that e-health interventions can improve QoL, reduce anxiety, and decrease depression in adult BC patients. However, no noticeable impact on reducing distress levels was observed. Additionally, given the diversity of interventions, these results should be interpreted with caution. To determine the optimum duration, validate different intervention approaches, and address methodological gaps in previous studies, more extensive clinical studies are needed.

Background: The treatment landscape in HR+/HER2− metastatic breast cancer (mBC) is continuously evolving, with evidence on new agents and combinations published almost every year. Despite updated therapeutic guidelines, second-line (2L) selection may be challenging due to clinical factors, biomarker status, and available agents. Methods: A two-round Delphi consensus was organized in July 2024, gathering input from 10 experts in research, diagnosis, and treatment of HR+/HER2− mBC on optimal 2L and beyond choice, considering the available biomarkers and results from published clinical trials. Consensus was defined as 70% agreement or disagreement. Results: The experts considered initially a list of 39 statements, structured into the following four sections: biomarker testing; selection of 2L treatment at progression of disease on first line endocrine therapy (ET) + CDK4/6i at ≥6 months after initiation of ET for mBC; selection of 2L treatment at disease progression on ET + CDK4/6i, at <6 months after initiation of ET for mBC, whilst on ET; and selection of post-2L treatment options. After a discussion, the experts decided to remove four statements, refine ten, and include three new ones. The final list consisted of 38 statements, and consensus was achieved in 37. Conclusions: The panel recommends next-generation sequencing as the method of choice for genomic characterization at disease progression on first line. The optimal agent or treatment class is indicated depending on the presence of specific mutations; however, the panel admits that the strategy is different in clinical practice, where novel therapies might not be available or reimbursed.