Expert consensus on treating HR+/HER2- metastatic breast cancer based on real-world practice patterns observed in the RETRACT survey of US oncologists

Hormone receptor-positive, HER2-negative metastatic breast cancer (HR+/HER2-mBC) is incurable, but recent progress has been made in developing new treatment options and the treatment landscape is rapidly shifting. There are published recommendations for treatment choices and sequencing to help guide oncologists in treating HR+/HER2-mBC, but little evidence has been published regarding real-world practice patterns. The REal-world TReatment patterns And Considerations of Toxicity in HR+/HER2-mBC (RETRACT) survey was designed to evaluate real-world practice patterns in the testing and management of this disease by US oncologists. The survey questions were answered via an online platform and the data were anonymized before analysis. A total of 150 oncologists practicing at academic and community centers completed the survey. The results showed this sample of oncologists largely followed recommended best practices for testing biomarkers, selecting treatments, and managing adverse events. However, several items did show substantial minorities of oncologists not in alignment with recommendations in areas including the definition and treatment of visceral crisis, ideal treatment for patients with endocrine resistance, the routine use of next-generation sequencing for biomarker testing, and the use of prophylactic measures for treatment-related adverse events in patients receiving alpelisib.