REAL Canadian Breast Cancer Alliance Collection

A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Breast Cancer".

Deadline for manuscript submissions: 31 December 2026 | Viewed by 6891

Special Issue Editors


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Guest Editor
1. Division of Medical Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON M4N 0A4, Canada
2. Division of Medical Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON M5S 1A1, Canada
Interests: brain metastases; breast cancer clinical trials; translational science

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Guest Editor
1. Medical Oncology, BC Cancer Agency, Vancouver, BC V5Z 4E6, Canada
2. Faculty of Medicine and Health Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 4E6, Canada
Interests: development of personalized oncology and the improvement of patient outcomes and survivorship programs
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
1. Medical Oncology, McGill University Health Center, Montreal, QC H4A 3J1, Canada
2. Department of Medicine, McGill University, Montreal, QC H3G 2M1, Canada
Interests: breast cancer clinical trial and translational research
1. Medical Oncology, Saskatoon Cancer Centre, Saskatoon, SK S7N 4H4, Canada
2. College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 4H4, Canada
Interests: real-world; quality improvement; breast cancer; guidelines

Special Issue Information

Dear Colleagues,

The Research Excellence, Active Leadership (REAL) Canadian Breast Cancer Alliance is a standing nucleus committee composed of clinical–academic physicians specializing in breast cancer from across Canada and Breast Cancer Canada, a patient organization. The REAL Alliance was formed and launched in December 2023 due to recognition that national collaboration is needed to address an unmet need: evidence-based guidance and recommendations, with timely updates, for use with public and government stakeholders for equitable and timely access to treatment and care for breast cancer patients. This special issue will provide guidance to physicians, other health care professionals, and policy makers for improving outcomes for patients with breast cancer across Canada.

Dr. Katarzyna J. Jerzak
Dr. Nathalie LeVasseur
Dr. Nathaniel Bouganim
Dr. Mita Manna
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Current Oncology is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Publisher’s Notice

As stated above, the central purpose of this Special Issue is to present research from the REAL Canadian Breast Cancer Alliance Collection. Given this purpose, the Guest Editors’ contribution to this Special Issue may be greater than typical of standard Special Issues published by MDPI. Further details on MDPI's Special Issue guidelines can be found here: https://www.mdpi.com/special_issues_guidelines. The Editorial Office and Editor-in-Chief of Current Oncology has approved this, and MDPI’s standard manuscript editorial processing procedure (https://www.mdpi.com/editorial_process) will be applied to all submissions. As per our standard procedure, Guest Editors are excluded from participating in the editorial process for their submission and/or for submissions from persons with whom a potential conflict of interest may exist. More details on MDPI’s Conflicts of Interest policy for reviewers and editors can be found here: https://www.mdpi.com/ethics#_bookmark22.

Keywords

  • HER2-positive
  • hormone receptor-positive
  • triple-negative
  • metastatic breast cancer
  • early-stage breast cancer
  • Canadian consensus recommendations
  • evidence-based
  • REAL Alliance

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Published Papers (4 papers)

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38 pages, 10403 KB  
Guidelines
Guidance for Canadian Breast Cancer Practice: National Consensus Recommendations for the Systemic Treatment of Patients with Triple Negative Breast Cancer in Both the Early and Metastatic Setting 2025
by Christine Simmons, Omar F. Khan, Christine Brezden-Masley, David W. Cescon, Anil Abraham Joy, Nathalie LeVasseur, Katarzyna J. Jerzak, Karen A. Gelmon, Sandeep Sehdev, Stephen Chia, Marc Webster, Scott Edwards, Aalok Kumar, Jeffrey Q. Cao, Jean-François Boileau, Kara Laing, Nathaniel Bouganim, Mita Manna and on behalf of Patient Advocacy, Breast Cancer Canada
Curr. Oncol. 2026, 33(5), 243; https://doi.org/10.3390/curroncol33050243 - 24 Apr 2026
Viewed by 376
Abstract
Triple-negative breast cancer (TNBC) has been associated with a poorer prognosis than other subtypes, due to its more aggressive behaviour. Since 2020, significant advances in locoregional and systemic therapy have improved outcomes for patients with TNBC, but the implementation of these treatments remains [...] Read more.
Triple-negative breast cancer (TNBC) has been associated with a poorer prognosis than other subtypes, due to its more aggressive behaviour. Since 2020, significant advances in locoregional and systemic therapy have improved outcomes for patients with TNBC, but the implementation of these treatments remains inconsistent across Canada. There is, therefore, a critical need for evidence-informed, consensus-driven guidance to support the integration of new therapies into practice. Research Excellence, Active Leadership Canadian Breast Cancer Alliance (REAL Alliance), a pan-Canadian group of breast cancer specialists and Breast Cancer Canada, a patient advocacy organization, convened to develop national clinical consensus recommendations for the management of breast cancer. Through a selective literature review and modified Delphi process of national experts in the fields of medical oncology, radiation oncology, surgical oncology and pharmacy, REAL Alliance developed national consensus recommendations for the management of TNBC. The result is a set of 23 recommendations: four overall general recommendations, 11 in early-stage TNBC, and eight in metastatic TNBC. These recommendations are intended for oncology healthcare professionals, and are intended to guide evidence-informed, consistent care across Canada. Full article
(This article belongs to the Special Issue REAL Canadian Breast Cancer Alliance Collection)
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25 pages, 1649 KB  
Guidelines
Guidance for Canadian Breast Cancer Practice: National Consensus Recommendations for the Systemic Treatment of Patients with HER2+ Breast Cancer in Both the Early and Metastatic Settings (2025 Update)
by Aalok Kumar, Katarzyna J. Jerzak, Karen A. Gelmon, Jean-François Boileau, Nathaniel Bouganim, Christine Brezden-Masley, Jeffrey Q. Cao, David W. Cescon, Stephen Chia, Scott Edwards, Anil Abraham Joy, Kara Laing, Nathalie LeVasseur, Sandeep Sehdev, Christine Simmons, Marc Webster, Mita Manna and on behalf of Patient Advocacy, Breast Cancer Canada
Curr. Oncol. 2026, 33(4), 200; https://doi.org/10.3390/curroncol33040200 - 31 Mar 2026
Viewed by 1201
Abstract
Human epidermal growth factor receptor 2-positive (HER2+) breast cancer is an aggressive subtype associated with a poor prognosis when not optimally treated. Over the past year, major advances—including results from DESTINY-Breast05, DESTINY-Breast09, DESTINY-Breast11, PATINA, and long-term APHINITY follow-up—have changed the treatment landscape regarding [...] Read more.
Human epidermal growth factor receptor 2-positive (HER2+) breast cancer is an aggressive subtype associated with a poor prognosis when not optimally treated. Over the past year, major advances—including results from DESTINY-Breast05, DESTINY-Breast09, DESTINY-Breast11, PATINA, and long-term APHINITY follow-up—have changed the treatment landscape regarding the place in therapy of antibody–drug conjugates and the optimal sequencing of systemic therapies. These developments prompted the need for updated evidence-informed consensus recommendations to support consistent, high-quality care across Canada. Research Excellence, Active Leadership Canadian Breast Cancer Alliance (REAL Alliance), comprising clinical-academic oncologists from across Canada and Breast Cancer Canada, updated its 2024 HER2+ recommendations through a modified Delphi process with up to three rounds of anonymous voting. Consensus was defined a priori as ≥75% agreement. This 2025 update incorporates new data in early-stage, metastatic, and central nervous system-involved disease, including revisions to neoadjuvant and adjuvant treatment pathways and expanded guidance on the clinical use of antibody–drug conjugates. Full article
(This article belongs to the Special Issue REAL Canadian Breast Cancer Alliance Collection)
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38 pages, 2496 KB  
Guidelines
Guidance for Canadian Breast Cancer Practice: National Consensus Recommendations for the Systemic Treatment of Patients with HR+/HER2− Early Breast Cancer 2025
by Sandeep Sehdev, Anil Abraham Joy, Jean-François Boileau, Nathaniel Bouganim, Christine Brezden-Masley, Jeffrey Q. Cao, David W. Cescon, Stephen Chia, Scott Edwards, Karen A. Gelmon, Katarzyna J. Jerzak, Aalok Kumar, Kara Laing, Nathalie LeVasseur, Christine Simmons, Marc Webster, Mita Manna and on behalf of Patient Advocacy, Breast Cancer Canada
Curr. Oncol. 2026, 33(2), 112; https://doi.org/10.3390/curroncol33020112 - 12 Feb 2026
Viewed by 2035
Abstract
Hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2−) early breast cancer (EBC) is the most common breast cancer subtype and encompasses a biologically heterogeneous group of tumours. Endocrine therapy (ET) remains the cornerstone of treatment, but decisions regarding chemotherapy, cyclin-dependent kinase 4 [...] Read more.
Hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2−) early breast cancer (EBC) is the most common breast cancer subtype and encompasses a biologically heterogeneous group of tumours. Endocrine therapy (ET) remains the cornerstone of treatment, but decisions regarding chemotherapy, cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors, and bone-modifying agents must be tailored to tumour biology, clinical stage, and menopausal status. REAL Canadian Breast Cancer Alliance (REAL Alliance), a pan-Canadian group of breast cancer specialists, convened to develop national clinical consensus recommendations for the systemic management of HR+/HER2− EBC. Using a structured consensus process, 28 recommendations were endorsed, spanning neoadjuvant and adjuvant systemic therapy, surgical considerations, and use of bisphosphonates. Key recommendations include the selective use of neoadjuvant chemotherapy for high-risk or locally advanced disease; genomic testing to guide chemotherapy decisions, particularly in postmenopausal patients; ET as the foundation of adjuvant therapy with intensification using CDK4/6 inhibitors in higher-risk patients; and adjuvant bisphosphonates in postmenopausal women to reduce recurrence and improve survival. These consensus recommendations provide practical, evidence-based guidance to support individualized, patient-centred management of HR+/HER2− EBC in the Canadian context. Full article
(This article belongs to the Special Issue REAL Canadian Breast Cancer Alliance Collection)
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36 pages, 1443 KB  
Guidelines
Guidance for Canadian Breast Cancer Practice: National Consensus Recommendations for the Systemic Treatment of Patients with HR+/HER2− Metastatic Breast Cancer 2025
by Katarzyna J. Jerzak, Aalok Kumar, Jean-François Boileau, Nathaniel Bouganim, Christine Brezden-Masley, Jeffrey Q. Cao, David W. Cescon, Stephen Chia, Scott Edwards, Anil Abraham Joy, Kara Laing, Nathalie LeVasseur, Sasha Lupichuk, Sandeep Sehdev, Christine Simmons, Marc Webster, Karen A. Gelmon, Mita Manna and on behalf of patient advocacy, Breast Cancer Canada
Curr. Oncol. 2026, 33(2), 106; https://doi.org/10.3390/curroncol33020106 - 9 Feb 2026
Cited by 1 | Viewed by 2382
Abstract
Hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) breast cancer accounts for approximately two-thirds of all breast cancers. The treatment landscape for HR+/HER2− metastatic breast cancer has evolved in recent years, with multiple new therapies demonstrating clinical efficacy and improved [...] Read more.
Hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) breast cancer accounts for approximately two-thirds of all breast cancers. The treatment landscape for HR+/HER2− metastatic breast cancer has evolved in recent years, with multiple new therapies demonstrating clinical efficacy and improved patient outcomes. To provide evidence-informed guidance on best practices in the management of patients with HR+/HER2− metastatic breast cancer in Canada, consensus recommendations were developed by Research Excellence, Active Leadership Canadian Breast Cancer Alliance (REAL Alliance), a standing nucleus committee with both clinical–academic oncologists from across Canada and representatives from Breast Cancer Canada, a patient advocacy organization. Recommendations were generated using a modified Delphi approach involving up to three anonymous voting rounds, with a predefined consensus threshold of 75%. These consensus recommendations offer guidance on optimal therapeutic strategies for HR+/HER2− metastatic breast cancer within the Canadian landscape, including integration of precision oncology and targeted therapies, optimal sequencing of therapies, and the importance of balancing the benefits of treatments with patient quality of life and preferences. Full article
(This article belongs to the Special Issue REAL Canadian Breast Cancer Alliance Collection)
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