GRAND ROUNDS: CHALLENGING ADVANCED BREAST CANCER. ONE YEAR LATER

The aim of the event is to stimulate a constructive comparison on the choices to be made in clinical practice among the specialists involved in the breast cancer experts involved, in order to offer patients the best possible treatment and make the therapeutic choices more homogeneous in light of the availability of cycline kinase-dependent inhibitors in the Her2 negative hormone-sensitive metastatic patient, which imposed a new therapeutic algorithm. In fact, each new acquisition induces changes, sometimes sensitive, of diagnostic-therapeutic behaviors, methods and procedures that require standardization and homogeneity of application.

Treatment of HER2-positive disease is an evolving area of work. While there is a perception of the need to increase the effectiveness of treatments through innovative and increasingly active drugs, there is also a need to save high-impact therapies when it is possible to offer the same benefits with weakened pharmacological treatments. The optimization of antiHER2 treatments and the customization of therapy still remain needs that are not fully matched, in a scenario that is continuously measured between innovation and sustainability.

After a review of the major scientific evidence, we will discuss together using a series of clinical case studies with in-depth decision-making, which will analyze the pros and cons of each therapeutic choice. In order to reproduce clinical practice as much as possible, it is necessary for the centers involved to be present with the reference specialists (Oncologist, Surgeon, Senologist, Radiotherapist Oncologist, Pathologist).

In this Covid-19 epidemics scenario the management of cancer patients requires particular attention. Taking into accounts these observations a web-based meeting is advisable as the best option.

DAY ONE: THE ER/PGR+ HER- DISEASE

NOVEMBER, 6^th

15.00                   Registraion

15.30                   Opening Address

16.00-17.30       CASE N. 1 : Outpatient session (recorded)

                              Managing physicians – Vittorio Gebbia , Maria Rosaria Valerio       

° First visit: case presentation, medical history, staging, co-morbidity analysis, treatment choice,                                               prescription and informed consent

° Second visit: efficacy and toxicity outputs, types of controls, prescription of future controls

° Third visit: efficacy and toxicity outputs, prescription of controls

° Fourth visit: final efficacy and toxicity outputs, prescription of controls

                               Plenary session:

                               Chairmans: Vincenzo Adamo, Saverio Cinieri

                                Video presentation of critical issues (recorded)

° Inside molecular biology of CDKi pathways – Paolo Vigneri

° Staging and reevaluation of disease – Giuseppina Ricciardi

° Criteria for treatment choice -  Maria Rosaria Valerio

° Comorbidity and CDKi treatment - Giuseppina Scandurra

Provokers and Round table: Paolo Tralongo, Stefano Vitello, Domenico Bilancia, Mariagrazia Morritti,                                   Livio Blasi, Loredana Lo Giudice, Antonino Iaria

                                Take home messages: Paolo Vigneri

17.30-19.00          CASE N. 2 : Outpatient session (recorded)

                                Managing physicians – Paolo Vigneri 

° First visit: case presentation: medical history, staging, co-morbidity analysis, treatment choice,                                               prescription and informed consent.

° Second visit: efficacy and toxicity outputs, types of controls, prescription of future controls

° Third visit: efficacy and toxicity outputs, prescription of controls

° Fourth visit: final efficacy and toxicity outputs, prescription of controls

                                 Plenary session.

                                 Chairman: Francesco Ferraù, Giammarco Surico

                                 Video presentation of critical issues (recorded):

° Toxicity management – Angela Prestifilippo                             

° Stereotaxic radiotherapy in oligo-progression – Gianluca Mortellaro

° Brain metastases -  Antonio Pontoriero, Mariacarmela Santarpia

° Second-line choice - Marco Messina

Provokers and Provokers: Massimiliano Spada, Liborio Di Cristina, Francesco Giotta, Stefano Pergolizzi, Francesco Verderame, Gianfranco Pernice, Tindara Franchina

19.00-19.15   Take home message: Vittorio Gebbia

DAY TWO: THE HER+ DISEASE

NOVEMBER, 7^th

09.00-10.30          CASE N. 3 – NEOADIUVANT MEDICAL TREATMENT

                                 Outpatient session (recorded)

                                 Managing physicians – Vittorio Gebbia

° First visit: case presentation, medical history, staging, co-morbidity analysis, treatment choice,                                               prescription and informed consent.

° Second visit: efficacy and toxicity outputs, types of controls, prescription of future controls

° Third visit: efficacy and toxicity outputs, prescription of controls

° Fourth visit: final efficacy and toxicity outputs, prescription of controls

                               Plenary session:

                               Chairman: Pierosandro Tagliaferri, Salvatore Pisconti

                               Video presentation of critical issues (recorded):

° Clinical Staging - Gabriella Bini

° Treatment Choice - Eugenia Arrivas Bajardi

° Toxicity management - Mariavita Sanò

° Outcomes Evaluation - Domenico Santangelo

Provokers and Round Table: Nicolò Borsellino, Nicoletta Staropoli, Francesco Caruso, Michele Caruso, Francesca Catalano, Sara Pettinato, Francesco Lo Sardo, Naida Faldetta, Calogero Cipolla, Salvatore Vieni, Roberto Gennari, Luisa Puzzo, Mario Mesiti, Salvatore D'Arpa, Gabriella Militello

                                Take home message: Michele Caruso

10.30-12.00            CASE N. 4 - ADIUVANT MEDICAL TREATMENT

                                   Outpatient session (recorded):

                                   Managing physicians – Paolo Vigneri

° First visit: case presentation, medical history, staging, co-morbidity analysis, treatment choice,                                               prescription and informed consent.

° Second visit: efficacy and toxicity outputs, types of controls, prescription of future controls

° Third visit: efficacy and toxicity outputs, prescription of controls

° Fourth visit: final efficacy and toxicity outputs, prescription of controls

                                   Plenary session:

                                   Chairman: Pierpaolo Correale

                                   Video presentation of critical issues (recorded):

° Clinical Staging - Vita Baldassara Leonardi

° Treatment Choice - Monica Firrinceli

° Toxicity management – Giuseppe Lavenia

° Outcomes Evaluation - Rosalia Nicastro

Provokers and Round table:  Carmelo Giorgio Giannitto, Ivan Fazio, Stefano Cordio, Antonio Savarino, Dario Giuffrida, Maria Teresa Catarella, Pietro Spadaro

                                   Take home messages: Dario Giuffrida

12.00-12.15             Conclusion: Paolo Vigneri, Vittorio Gebbia

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