Evidence-Based Consensus on the Diagnosis and Treatment of Advanced HER2-Positive and HER2-Low Breast Cancer in Colombia

TL;DR

This paper provides updated clinical guidelines for treating advanced HER2-positive and HER2-low breast cancer in Colombia, aiming to standardize care and improve patient outcomes.

Contribution

The study offers the first evidence-based, nationally tailored clinical recommendations for HER2-related breast cancer in Colombia.

Findings

Twenty-two clinical recommendations were developed, covering diagnosis, treatment, and management of brain metastases.

Five recommendations were strong, while 17 were conditional due to local resource constraints.

The guidelines aim to standardize care and promote equitable access to therapies in Colombia.

Abstract

Background/Objectives: The management of advanced HER2-positive and HER2-low breast cancer is evolving rapidly. This study aimed to generate national, evidence-based clinical recommendations for Colombia, addressing the lack of standardized local guidance. Methods: A systematic literature search (2020–2024) was conducted. The evidence was evaluated using AGREE II, RoB 2, ROBINS-I, and JBI tools. Recommendations were developed using the GRADE approach and a structured modified Delphi consensus process involving 34 national experts. Results: A total of 22 clinical recommendations were formulated. These address HER2 quantification and reporting, first-line and subsequent-line therapy, and management of brain metastases. Five recommendations (23%) were classified as strong, supported by high-certainty evidence, while 17 (77%) were conditional, reflecting the need for adaptation to local contexts and resource availability. Conclusions: This consensus provides updated, context-specific clinical guidance to optimize the care of patients with advanced HER2-positive and HER2-low breast cancer in Colombia. The recommendations are designed to standardize care, improve patient outcomes, and promote equitable access to innovative therapies within the Colombian healthcare system.

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