Evidence map›Paper›PMID 42629540›Full record

GuidelineInternational journal of clinical oncology2026

Pharmacotherapy for older adults with cancer: a digest of the Japanese clinical practice guidelines (second edition)-breast cancer.

Yuko Takano, Akihiko Shimomura, Sachi Morita, Taijiro Kosaka, Yumiko Koi, Emi Tokuda, Fumio Nagashima, Ayumu Matsuoka, Masataka Sawaki, JSMO/JSCO Clinical Practice Guideline Committee for Pharmacotherapy in Older Adults with Cancer

Abstract readPractice Guideline
PubMed Publisher
In one paragraph

Guideline in International journal of clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Yuko TakanoDepartment of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan.ORCID http://orcid.org/0000-0002-3753-7683
Akihiko ShimomuraDepartment of Breast and Medical Oncology, National Center for Global Health and Medicine, Tokyo, Japan.
Sachi MoritaDepartment of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan.
Taijiro KosakaDepartment of Breast Surgery, Saku Central Hospital, Nagano, Japan.
Yumiko KoiDepartment of Breast Oncology, NHO Kyushu Cancer Center, Fukuoka, Japan.
Emi TokudaDepartment of Medical Oncology, Fukushima Medical University, Fukushima, Japan.
Fumio NagashimaDepartment of Medical Oncology, Faculty of Medicine, Kyorin University, Tokyo, Japan.
Ayumu MatsuokaDivision of Survivorship Research, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan.
Masataka SawakiDepartment of Breast Oncology, Nagoya Medical Center, National Hospital Organization (NHO), 4-1-1 Sannomaru, Naka-ku, Nagoya, Aichi, 460-0001, Japan. masataka.sawaki@outlook.jp.
JSMO/JSCO Clinical Practice Guideline Committee for Pharmacotherapy in Older Adults with Cancer

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe number of older adults with early breast cancer is rising in aging societies. Optimal perioperative systemic therapy for this population remains challenging, owing to heterogeneity in functional status, comorbidities, and the limited representation of older patients in clinical trials.

methodsThis article presents an English digest of the Japanese Clinical Practice Guidelines for Pharmacotherapy in Older Adults with Cancer (Second Edition), focusing on perioperative systematic therapy for early breast cancer. The guidelines were developed in accordance with the Minds 2020 methodology, incorporating systematic reviews, the Evidence-to-Decision framework, and multidisciplinary consensus.

resultsThe guidelines address key clinical questions regarding perioperative systemic therapy for older patients with breast cancer, including human epidermal growth factor receptor 2 (HER2)-targeted therapy, immune checkpoint inhibitors, and treatment intensification strategies for hormone receptor-positive disease. Most recommendations are conditional because of limited direct evidence in older populations. Trastuzumab-based therapy remains the standard approach for HER2-positive disease, whereas alternative strategies may be considered for patients who are unable to tolerate chemotherapy. Immune checkpoint inhibitors combined with chemotherapy may improve recurrence-related outcomes in selected patients; however, evidence in older populations is limited. Additional therapies, such as abemaciclib or S-1, may reduce the risk of recurrence in high-risk patients but require careful consideration of toxicity.

conclusionsThese guidelines provide practical, evidence-based recommendations for perioperative systemic therapy in older adults with early breast cancer. They emphasize individualized treatment strategies that integrate patient characteristics, treatment goals, and tolerability. Further research specifically targeting older populations is needed to strengthen the evidence base for geriatric oncology.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsAgedErb-b2 Receptor Tyrosine KinasesFemaleHumansJapanERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesBreast cancerClinical practice guidelinesGeriatric oncologyOlder adultsPharmacotherapy

Identifiers

PMID42629540

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.