SITC Breast Cancer
Immunotherapy Guideline

SITC's Cancer Immunotherapy Guidelines program is a
collection of Clinical Practice Guidelines (CPGs) developed by multi-disciplinary panels of experts who draw from their own practical experience as  well as evidence in the published literature and clinical trial data to develop evidence- and consensus-based recommendations. SITC uses as a model the Institute of Medicine's 2011 "Standards for Developing Trustworthy Clinical Practice Guidelines" to ensure the recommendations are unbiased, transparent and balanced will aid oncologists in effective clinical decision-making concerning patient selection, toxicity management, response evaluation, and the sequencing or combination of therapies, among other topics.

The Breast Cancer Immunotherapy Guideline Expert Panel was formed to generate consensus recommendations pertaining to the treatment of patients with breast cancer. In March 2019, accelerated approval was granted by the U.S. FDA for the checkpoint inhibitor atezolizumab in combination with chemotherapy for the treatment of PD-L1+ advanced or metastatic triple-negative breast cancer (TNBC)—the first immuno-oncology agent approval for this disease setting. Trials are ongoing evaluating other immunotherapeutic agents as monotherapies and combination regimens for the treatment of TNBC and other breast cancer subtypes. Reflecting the evolving therapeutic landscape, SITC is currently developing a breast cancer CPG with topics including selection of appropriate immunotherapeutic regimens, companion diagnostics, recognition and management of adverse events, and patient quality of life considerations.

Current Guideline

Published August 13, 2021 in the Journal for ImmunoTherapy of Cancer (JITC) as "Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of breast cancer"

READ GUIDELINE

Webinar Series

SITC is pleased to offer companion education resources in support of the breast cancer CPG. These activities feature faculty comprised of the guideline Expert Panel and are designed to provide a deeper understanding of the recommendations in the SITC guidelines and how to apply them in various clinical scenarios.  The education available features both webinars that take a deeper look at the guideline recommendations and mini-module videos on a specific topic within the guideline content. Below is a list of the available educational resources for this CPG, available free and on-demand.

Webinars:

• Immunotherapy for the Treatment of Breast Cancer Guideline Overview
  • Leading experts in cancer immunotherapy presented an overview of the publication "Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of breast cancer" during a live webinar.

• Practical Management Pearls for Immunotherapy for the Treatment of Breast Cancer- SITC CPG Webinar
  • This advanced webinar explains how to appraise and classify organ-specific considerations for immunotherapy agents and toxicities, identify and manage clinically significant uncommon toxicities, and determine optimal sequencing of immunotherapies in relapsed and/or refractory disease.

• Case Studies in Immunotherapy for the Treatment of Breast Cancer- SITC CPG Webinar
  • This high-level webinar will include case studies that illustrate execution of guideline recommendations, as well as discussion on difficult topics related to case management, as outlined in the Breast Cancer CPG.

Mini-Modules:

• First-Line Treatment of Metastatic TNBC
  • Heather McArthur, MD, MPH - UT-Southwestern provides a thorough description of studies supporting current recommendations for treatment of metastatic, triple negative breast cancer.  Details of PD-L1 testing in advanced/metastatic breast cancer are also discussed.
• Neoadjuvant and Adjuvant Treatment
  • In this module, Kevin Kalinsky, MD, MS - Winship Cancer Institute, Emory University, discusses data supporting the use of neoadjuvant chemotherapy with immune checkpoint inhibitors for treatment of triple negative breast cancer.  Ongoing investigations on the efficacy of adjuvant chemotherapy in combination with immune checkpoint inhibitors are alsoa addressed. 
• Toxicities and Adverse Events
  • This module begins with an overview of immune-related adverse events and toxicities from Jennifer Litton, MD - The University of Texas MD Anderson Cancer Center.  Kevin Kalinsky, MD, MS - Winship Cancer Institute, Emory University, and Heather McArthur, MD, MPH - UT Southwestern, then provide case presentations that underscore the importance of vigilance, early intervention, and a multi-disciplinary approach when managing toxicities and adverse events in patients receiving immunotherapy for triple negative breast cancer.