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 recommendations are unbiased, transparent, and balanced. 

The breast cancer guideline provides a valuable clinical decision-making tool to help guide oncologists and other advanced practice providers on topics including biomarkers, the selection of appropriate immunotherapeutic regimens, treatment response and monitoring, toxicity management, and patient quality of life considerations. 

Published Guideline

READ GUIDELINE

"Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of breast cancer" published on August 13, 2021 in the Journal for ImmunoTherapy of Cancer (JITC) and has since been updated.

SITC continuously evaluates the field for practice-changing data and new FDA approvals. When needed, the Breast Cancer CPG Expert Panel guides the development of updates within this CPG. Updates appear in the SITC CPG Mobile App and as annotated text accompanying the original publication in JITC.

Updated Content (last reviewed 3/15/24)

• Update v1.2 – Updates to the narrative text and recommendations based on the accelerated approval of dostarlimab for the treatment of dMMR recurrent or advanced solid tumors (along with the VENTANA MMR RxDx Panel companion diagnostic) that have progressed on or following prior treatment and who have no satisfactory alternative treatment options.
  • Table 2 was updated to include GARNET trial data that led to the tissue-agnostic approval of dostarlimab.
• Update v1.1(A) - Updates to narrative text and recommendations based on the voluntary withdrawal of the indication for atezolizumab in combination with nab-paclitaxel for treatment of PD-L1-positive TNBC.

Download the app for quick access to the breast cancer CPG with interactive tools and companion education resources.

Guideline Education

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 CPG Overview
  • Leading experts in cancer immunotherapy present an overview of the "Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of breast cancer."
    

• Practical Management Pearls for Immunotherapy for the Treatment of Breast Cancer
  • This one hour on-demand webinar features members of the guideline Expert Panel. These faculty members discuss 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
  • This one hour on-demand webinar features members of the guideline Expert Panel. These faculty members discuss case studies that illustrate execution of SITC guideline recommendations, as well as discussion on difficult topics related to case management.

Mini-Modules:

• First-Line Treatment of Metastatic TNBC
  • Expert Panel member Heather McArthur, MD, MPH, 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
  • Expert Panel member Kevin Kalinsky, MD, MS, 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 also addressed. 

• Toxicities and Adverse Events
  • Expert Panel members provide an overview of immune-related adverse events and toxicities. Case presentations 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. 

For questions regarding SITC CPGs, please contact a member of the Scientific Publications Department at scientificresources@sitcancer.org.