{"entity":{"id":"paper-st-gallen-2025-consensus-ann-oncol-2025","kind":"paper","name":"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","aka":[],"tldr":"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.","asOf":"2026-09-24","links":[{"label":"Ann Oncol 2025","url":"https://doi.org/10.1016/j.annonc.2025.09.007"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/41072918/"}],"tags":["tnbc-evidence"],"related":[],"cancers":["tnbc","breast-hr-positive","breast-her2-positive"],"sections":[],"technologies":["platinum","checkpoint-inhibitor"],"targets":[],"drugs":["carboplatin","pembrolizumab"],"companies":[],"institutions":[],"pathways":[],"terms":["germline-testing","de-escalation"],"trials":["keynote-522"],"people":["giuseppe-curigliano","sibylle-loibl"],"bottlenecks":[],"keyPapers":[],"journals":["annals-of-oncology"],"dependsOn":[],"notes":[],"journal":"Annals of Oncology","year":2025,"doi":"10.1016/j.annonc.2025.09.007","pmid":"41072918","authors":"Burstein HJ, Curigliano G, Gnant M, et al.","paperType":"guideline","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."],"whatItMeans":"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."],"changedPractice":true},"route":"/key-papers/paper-st-gallen-2025-consensus-ann-oncol-2025/","neighbours":{"cancer":[{"id":"breast-her2-positive","kind":"cancer","name":"HER2-positive breast cancer","route":"/cancers/breast-her2-positive/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"technology":[{"id":"germline-testing","kind":"technology","name":"Germline (hereditary) testing","route":"/technologies/germline-testing/"},{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"},{"id":"platinum","kind":"technology","name":"Platinum agents","route":"/technologies/platinum/"}],"drug":[{"id":"carboplatin","kind":"drug","name":"Carboplatin","route":"/drugs/carboplatin/"},{"id":"pembrolizumab","kind":"drug","name":"Pembrolizumab","route":"/drugs/pembrolizumab/"}],"term":[{"id":"de-escalation","kind":"term","name":"De-escalation, escalation and response-adapted therapy","route":"/terms/de-escalation/"}],"trial":[{"id":"keynote-522","kind":"trial","name":"KEYNOTE-522","route":"/trials/keynote-522/"}],"person":[{"id":"giuseppe-curigliano","kind":"person","name":"Giuseppe Curigliano","route":"/people/giuseppe-curigliano/"},{"id":"sibylle-loibl","kind":"person","name":"Sibylle Loibl","route":"/people/sibylle-loibl/"}],"journal":[{"id":"annals-of-oncology","kind":"journal","name":"Annals of Oncology","route":"/journals/annals-of-oncology/"}],"roadmap":[{"id":"tnbc-roadmap","kind":"roadmap","name":"Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem","route":"/roadmaps/tnbc-roadmap/"}]}}