# Tailoring treatment to cancer risk and patient preference: the 2025 St Gallen International Breast Cancer Consensus Statement on individualizing therapy for patients with early breast cancer

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

## TL;DR

The 2025 international consensus on early breast cancer, which recommends platinum chemotherapy and immunotherapy for triple-negative disease, updated genetic testing guidance and shorter radiotherapy schedules.

## Summary

Consensus statement from the biennial St Gallen Breast Cancer Consensus conference by Burstein, Curigliano, Gnant, Loibl and colleagues. Innovations in 2025 include updated guidance on genetic testing; endorsement of hypofractionated and ultra-hypofractionated radiotherapy for more patients; a recommendation for platinum-based chemotherapy in triple-negative breast cancer and use of biological risk markers to consider anthracyclines in other subtypes; avoidance of sentinel lymph node surgery in many low-risk oestrogen receptor-positive cancers; use of immunotherapy in triple-negative and certain oestrogen receptor low-positive tumours; guidance on re-irradiation and systemic therapy at locoregional recurrence; criteria for oligometastatic disease; and survivorship recommendations on neuropathy and sexual health.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Tags: tnbc-evidence
- Journal: Annals of Oncology
- Year: 2025
- DOI: 10.1016/j.annonc.2025.09.007
- Authors: Burstein HJ, Curigliano G, Gnant M, et al.
- Findings: Platinum-based chemotherapy recommended in triple-negative breast cancer.; Immunotherapy recommended in triple-negative and certain oestrogen receptor low-positive tumours.; Updated genetic testing guidance and endorsement of hypofractionated and ultra-hypofractionated radiotherapy.
- What it means: Platinum and immunotherapy are now consensus for early triple-negative disease; the open votes have moved to who can safely receive less.
- Caveats: Expert consensus by vote.; Does not address the post-neoadjuvant antibody-drug conjugate trials, which had not reported.

## Sources

- Ann Oncol 2025: https://doi.org/10.1016/j.annonc.2025.09.007
- PubMed: https://pubmed.ncbi.nlm.nih.gov/41072918/

## Connected records

- cancers: [HER2-positive breast cancer](https://onco.cc/cancers/breast-her2-positive/), [HR-positive / HER2-negative breast cancer](https://onco.cc/cancers/breast-hr-positive/), [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- technologies: [Germline (hereditary) testing](https://onco.cc/technologies/germline-testing/), [Immune checkpoint inhibitors](https://onco.cc/technologies/checkpoint-inhibitor/), [Platinum agents](https://onco.cc/technologies/platinum/)
- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/)
- terms: [De-escalation, escalation and response-adapted therapy](https://onco.cc/terms/de-escalation/)
- trials: [KEYNOTE-522](https://onco.cc/trials/keynote-522/)
- people: [Giuseppe Curigliano](https://onco.cc/people/giuseppe-curigliano/), [Sibylle Loibl](https://onco.cc/people/sibylle-loibl/)
- journals: [Annals of Oncology](https://onco.cc/journals/annals-of-oncology/)
- roadmaps: [Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem](https://onco.cc/roadmaps/tnbc-roadmap/)

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