《2024 CSCO 乳腺癌指南》英文版全称为Chinese Society of Clinical Oncology (CSCO) Breast Cancer guidelines 2024National Center for Biotechnology Information，于 2024 年 7 月 25 日发表在《Transl Breast Cancer Res》期刊上National Center for Biotechnology Information。该指南结合国内外临床研究成果与中国药物可及性现状，采用分级推荐模式给出诊疗建议，还新增多个重点章节，适配中国及类似医疗环境国家的临床实践，以下是其核心内容整理National Center for Biotechnology Information：
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Basic Information
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Core Updated Content
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HER2-positive breast cancer：For neoadjuvant therapy and first-line metastatic therapy, the combination of trastuzumab and pertuzumab is a Level I recommendation. The 6-cycle THP regimen is also rated as a Level I recommendation, while the original 4-cycle THP regimen is adjusted to Level II. Pyrotinib is recommended as a Level I option for both first-line and second-line treatments relying on domestic research evidence. For patients with disease progression after trastuzumab treatment, antibody-drug conjugates are recommended. In terms of adjuvant therapy, for patients who only received trastuzumab before surgery and did not achieve pathological complete remission, the evidence level of T-DM1 as a Level I recommendation is upgraded from 1B to 1A, and neratinib is added as a Level III recommendation for subsequent intensive treatment.
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Triple-negative breast cancer (TNBC)：The guideline adds new chapters specifically for immunotherapy, highlighting its importance in early and metastatic TNBC. In neoadjuvant therapy, Level I recommendations include paclitaxel combined with anthracycline regimens and paclitaxel combined with platinum regimens; the combination of TP-AC and pembrolizumab, as well as TP plus PD-1 inhibitors, are also included in Level I recommendations. For adjuvant therapy, if the neoadjuvant treatment includes PD-1 inhibitors, continuing the medication for a full year is added as a Level II recommendation, and specific dosages and administration methods of capecitabine are clarified.
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HR-positive breast cancer：CDK4/6 inhibitors are recommended for multiple stages, especially adjuvant therapy. For patients with high recurrence risks (such as those with 4 or more positive lymph nodes), anastrozole combined with abemaciclib is a Level I recommendation. Based on the NATALEE clinical study, ribociclib is recommended for eligible patients. In addition, it is specified that if patients cannot tolerate abemaciclib due to adverse reactions, they can switch to ribociclib.
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HER2-low breast cancer：A new chapter is added in this guideline, which classifies and formulates treatment recommendations according to the HR status of patients. This fills the gap in the standardized treatment guidance for this type of breast cancer, which is a key adjustment to keep up with the refined classification trend of breast cancer diagnosis and treatment.