Articol susținut de S.N.O.M.R.

Mircea Dragos, Median¹, Nicoleta Zenovia Antone^2.*, Simona Volovăt^3.4, Laura Mazilu^5,6, Serban Mircea Negru^7,8, Răzvan Ovidiu Curcă⁹, Amedeia Nită¹⁰, Raluca Ileana Pătru¹¹, Andrei Ungureanu¹², Vlad Lupu^7,8,13, Cristina Marinela Oprean^8,13

1. Filantropia Clinical Hospital, 011132 Bucharest, Romania
2. Breast Tumors Center, Institute of Oncology “Prof. Dr. Ion Chiricuta”, 400015 Cluj-Napoca, Romania
3. Regional Institute of Oncology, 700483 Iasi, Romania
4. Department of Oncology and Radiotherapy, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
5. Ovidius Clinical Hospital, 905900 Constanta, Romania
6. Ovidius University, 900527 Constanta, Romania
7. Department of Oncology, Faculty of Medicine, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
8. Department of Oncology, ONCOHELP Hospital, 300239 Timisoara, Romania
9. Elysee Hospital, 510040 Alba Iulia, Romania
10. Municipal Hospital, 100337 Ploiesti, Romania
11. Coltea Clinical Hospital, 030167 Bucharest, Romania
12. Amethyst Radiotherapy Center, 407280 Cluj-Napoca, Romania
13. ANAPATMOL Research Center, ‘Victor Babes’ University ofMedicine and Pharmacy, 300041 Timisoara, Romania
* Correspondence: nicopopanton@yahoo.com or nicoleta.antone@iocn.ro ; Tel.: +40-740-226-786

Curr. Oncol. 2026, 33, 120

DOI: https://doi.org/10.3390/curroncol33020120

Abstract:
Breast cancer (BC) is the most common malignant disease in women in Romania, with incidence and mortality rates among the highest in Europe. This consensus statement aims to ensure equitable access to care for human epidermal growth factor receptor 2-negative metastatic BC (HR+/HER2– mBC) and triple-negative mBC (mTNBC) in Romania. Between December 2024 and June 2025, a scientific board of 11 oncologists, in collaboration with the Romanian National Society for Medical Oncology (SNOMR), developed national recommendations based on ESMO/NCCN/ABC guidelines, clinical expertise, and local conditions. A modified Delphi survey was conducted among medical oncologists to evaluate acceptance of recommendations with greatest clinical impact. Key recommendations included: mandatory biopsy at metastasis with ER/PgR/HER2 retesting, HER2-low assessment, and molecular profiling (BRCA, PIK3CA, AKT1/PTEN, ESR1, plus PD-L1 testing in mTNBC); for HR+/HER2– mBC, first-line endocrine therapy plus CDK4/6 inhibitor, followed by targeted agents, chemotherapy, or antibody–drug conjugates based on progression and visceral crisis; for mTNBC, first-line immune checkpoint inhibitor plus chemotherapy in PD-L1-positive, PARP inhibitors in BRCA-positive patients, and sacituzumab-govitecan or trastuzumab-deruxtecan later; systematic toxicity monitoring; and integrated supportive and palliative care. Sixty-one oncologists completed the survey, with >90% overall agreement, suggesting broad acceptance of recommendations as Romania’s national standard for mBC care.
Keywords:
consensus statement; hormone receptor-positive and human epidermal growth factor receptor 2-negative metastatic breast cancer (HR+/HER2– mBC); triple-negative metastatic breast cancer (mTNBC); Romania; guidelines; Delphi survey