# Updated treatment recommendations for systemic treatment: from the ESMO Metastatic Breast Cancer Living Guideline

Source: https://onco.cc/key-papers/paper-esmo-mbc-living-guideline-update-ann-oncol-2025/  
OnCo record `paper-esmo-mbc-living-guideline-update-ann-oncol-2025` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A 2025 letter recording the latest changes to Europe's continuously updated guideline for metastatic breast cancer, the mechanism through which first-line antibody-drug conjugate results enter European practice.

## Summary

Letter in Annals of Oncology (2025) by Trapani, Martins-Branco, Curigliano, Gennari and colleagues announcing updated systemic treatment recommendations from the ESMO Metastatic Breast Cancer Living Guideline. Europe PMC indexes no abstract, so OnCo carries no figures from it; the current recommendations are read from the living guideline on the ESMO website, which for triple-negative disease incorporates the first-line antibody-drug conjugate trials as they are published.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Tags: tnbc-evidence
- Journal: Annals of Oncology
- Year: 2025
- DOI: 10.1016/j.annonc.2025.07.017
- Authors: Trapani D, Martins-Branco D, Curigliano G, et al.
- Findings: No abstract is indexed on Europe PMC; the living guideline itself carries the recommendations.
- What it means: For a fast-moving disease the living guideline, not the 2021 paper, is where European recommendations for triple-negative breast cancer now change; readers should check the website rather than the journal.
- Caveats: A letter announcing updates, not a full guideline text.; No abstract indexed.

## Sources

- Ann Oncol 2025: https://doi.org/10.1016/j.annonc.2025.07.017
- PubMed: https://pubmed.ncbi.nlm.nih.gov/40930896/
- ESMO Metastatic Breast Cancer Living Guideline: https://www.esmo.org/living-guidelines

## Connected records

- key papers: [ESMO Clinical Practice Guideline for the diagnosis, staging and treatment of patients with metastatic breast cancer](https://onco.cc/key-papers/paper-esmo-metastatic-breast-cancer-guideline-ann-oncol-2021/)
- cancers: [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- institutions: [European Society for Medical Oncology (ESMO)](https://onco.cc/institutions/esmo/)
- people: [Giuseppe Curigliano](https://onco.cc/people/giuseppe-curigliano/)
- journals: [Annals of Oncology](https://onco.cc/journals/annals-of-oncology/)

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