{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T20:32:03Z","timestamp":1793305923321,"version":"4.5.0"},"reference-count":225,"publisher":"American Society of Clinical Oncology (ASCO)","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["J Clin Oncol"],"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Living guidelines are developed for selected topic areas with rapidly evolving evidence that drives frequent change in recommended clinical practice. Living guidelines are updated on a regular schedule by a standing expert panel that systematically reviews the health literature on a continuous basis, as described in the<\/jats:italic>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.asco.org\/practice-patients\/guidelines\/guideline-methodology\">\n                        <jats:italic toggle=\"yes\">ASCO Guidelines Methodology Manual<\/jats:italic>\n                      <\/jats:ext-link>\n                      .\n                      <jats:italic toggle=\"yes\">ASCO Living Guidelines follow the<\/jats:italic>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.asco.org\/about-asco\/legal\/conflict-interest-coi\">\n                        <jats:italic toggle=\"yes\">ASCO Conflict of Interest Policy Implementation for Clinical Practice Guidelines<\/jats:italic>\n                      <\/jats:ext-link>\n                      <jats:italic toggle=\"yes\">. Living Guidelines and updates are not intended to substitute for independent professional judgment of the treating clinician and do not account for individual variation among patients.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">\n                        Clinical Practice Guidelines and other guidance (\u201cGuidance\u201d) provided by ASCO is not a comprehensive or definitive guide to treatment options. It is intended for voluntary use by clinicians and should be used in conjunction with independent professional judgment. Guidance may not be applicable to all patients, interventions, diseases or stages of diseases. Guidance is based on review and analysis of relevant literature, and is not intended as a statement of the standard of care. ASCO does not endorse third-party drugs, devices, services, or therapies and assumes no responsibility for any harm arising from or related to the use of this information. See complete disclaimer in\n                        <jats:xref ref-type=\"app\">Appendix 1<\/jats:xref>\n                        and\n                        <jats:xref ref-type=\"app\">Appendix 2<\/jats:xref>\n                        (online only) for more.\n                      <\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To provide recommendations on use of medical therapies for patients with stage I to III hormone receptor\u2013positive, human epidermal growth factor receptor 2 (HER2)\u2013negative breast cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An Expert Panel including patient representation completed a systematic review of the evidence and formulated recommendations for practice. Eligible studies included patients with stage I to III hormone receptor\u2013positive, HER2-negative breast cancer and evaluated neoadjuvant or adjuvant chemotherapy, endocrine therapy (ET), immunotherapy, or targeted therapy. Outcomes of interest included pathologic complete response, disease-free survival, distant recurrence-free survival, overall survival, health-related quality of life, and treatment-related adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty-five randomized clinical trials (68 references) published from 2018 to 2026 were identified by the broad literature search. Supplemental searches identified six individual patient data meta-analyses and 21 retrospective studies that, combined with the primary clinical trials, informed guidance on which patients should receive treatment, which treatments should be selected, optimal treatment timing, duration of treatment, and approaches to support adherence. A final section addresses estimation of prognosis and treatment benefit to inform decisions across all phases of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Recommendations<\/jats:title>\n                    <jats:p>The recommendations are organized to follow the longitudinal care of patients with stage I to III hormone receptor\u2013positive, HER2-negative breast cancer, reflecting the sequence of decisions faced by clinicians from diagnosis through completion of systemic therapy. ET remains the foundation of treatment for stage I to III hormone receptor\u2013positive, HER2-negative breast cancer. For selected patients, chemotherapy and targeted therapies can further reduce the risk of recurrence and breast cancer death. Treatment recommendations should integrate clinicopathologic features, genomic assays, patient preferences, treatment tolerability, and estimated recurrence risk. The guideline provides evidence-based recommendations to support individualized treatment selection and sequencing across the continuum of care.<\/jats:p>\n                    <jats:p>\n                      Additional information is available on the\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/ascopubs.org\/guidelines\/living-guidelines\">ASCO Publications website<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco-26-02034","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:00:24Z","timestamp":1787774424000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":2,"title":["Medical Therapy for Hormone Receptor\u2013Positive, Human Epidermal Growth Factor Receptor 2\u2013Negative Stage I to III Breast Cancer: ASCO Living Guideline, Version 2026.1.0"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5711-8355","authenticated-orcid":false,"given":"Jennifer L.","family":"Caswell-Jin","sequence":"first","affiliation":[{"name":"Stanford University School of Medicine, Stanford, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5372-0085","authenticated-orcid":false,"given":"Mark R.","family":"Somerfield","sequence":"additional","affiliation":[{"name":"American Society of Clinical Oncology, Alexandria, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Ali","family":"Khan","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Phoenix, AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7096-9624","authenticated-orcid":false,"given":"Gretchen G.","family":"Kimmick","sequence":"additional","affiliation":[{"name":"School of Medicine, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shilpi","family":"Gupta","sequence":"additional","affiliation":[{"name":"Carol G. 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