In November, the ABC Global Alliance launched the Advanced Breast Cancer (ABC) Global Decade Report 2015-2025. This landmark global assessment reveals a decade of remarkable scientific progress that has transformed ABC care for some patients in some countries, while many others around the world have yet to benefit.

The results expose profound and persistent inequalities that leave many patients behind. The Report’s central theme, Knowledge in Motion, emphasises the urgent need to translate a decade of evidence and innovation into life-changing action for every person living with ABC.

These compelling findings drove the creation of the ABC Global Charter 2025-2035, also launched by ABC Global Alliance in November. The Charter sets out a new ten-year roadmap to drive equitable progress and transform care for everyone with ABC, regardless of where they live, their cancer subtype, or their socioeconomic status.

The report confirms that collective action over the past decade has yielded significant advances in ABC care, proving that progress is possible:

• The assumption that ABC is a rapid death sentence, and that money spent treating it is wasted, has been proven wrong. The five-year median overall survival rate for women with ABC has risen to 33%, up from 26% a decade ago, with real-world data showing median survival for HER2+ disease exceeding 50 months in some regions
• The first truly international consensus guidelines for the management of ABC have been embedded in practice across multiple regions
• New ways of connecting data have provided the first-ever reliable ABC prevalence estimates (an estimate of the number of people living with ABC) in countries like Australia and Northern Ireland
• Conversations around quality of life, stigma, workplace rights and psychological support have moved closer to the centre of global and national cancer policy.
• Nevertheless, the uneven distribution of progress has only widened the gap between what is possible and what remains the reality for the majority of patients:
• Median overall survival for triple-negative ABC has increased by less than three months in the past decade, remaining at just 13 months
• Disparities in access to biological or targeted therapies persist globally, with drugs such as trastuzumab – which, for the last two decades, has been the mainstay treatment for HER2+ ABC – available in only 51% of low-middle income countries vs 93% of high-income countries
• Over half of all people with ABC (55%) report that they have not been offered any support services by their healthcare team
• While some laws and workplace protections exist, no country has effectively implemented a comprehensive legal framework to fully protect the working rights of people with ABC and their informal caregivers.

The report draws on two global surveys conducted in 2024, including responses from 1,254 people with ABC across 59 countries and 461 healthcare professionals (HCPs) across 78 countries, both revealing the profound burden of ABC:

• Quality of life and psychosocial needs remain unmet:
• 79% of patients report that ABC has a negative impact on their emotional and psychological well-being
• Only 53% of HCPs report regularly referring patients to psychological support services.
• Access to innovative care is limited:
• 79% of people with ABC report never having participated in a clinical trial, a critical pathway for access to treatments
• High out-of-pocket costs are a global issue, with 60% of patients reporting a negative impact of ABC on their financial security.
• Stigma and isolation remain pervasive:
• Nearly half of people with ABC (47%) report that others do not understand their situation, leading to feelings of isolation, which can impact their quality of life.
• Workplace rights remain unprotected in many countries:
• 73% of people with ABC say the disease negatively affects their ability to work or study, with many facing a lack of support, difficulty returning to work or job loss.

To address these urgent challenges, the new ABC Global Charter sets out ten ambitious, measurable goals for the next decade, from ensuring high-quality data collection and registry standards, to improving the legal and workplace rights for patients and their informal caregivers.

1. Further improve survival in people with ABC by doubling median overall survival
2. Optimise care and outcomes for people with ABC by collecting high-quality data
3. Improve the quality of life of people with ABC
4. Ensure that every person with ABC is treated and cared for by a specialised multidisciplinary team according to high-quality guidelines
5. Improve communication between HCPs and people with ABC and their caregivers
6. Meet the informational needs of all people with ABC
7. Ensure all people with ABC have access to comprehensive, person-centred support services
8. Reduce misconceptions, stigma and isolation by improving understanding of ABC
9. Improve access to comprehensive care for people with ABC, regardless of their ability to pay
10. Improve the legal rights of people with ABC, including the right to continue or return to work.

The Advanced Breast Cancer Global Decade Report is a comprehensive global analysis of ABC over the last decade, drawing on surveys including responses from 1,254 patients and 461 healthcare professionals globally, as well as registry data interviews, targeted literature reviews, secondary research and expert consensus. The report was published with the support of health communications agency VML Health.

ABC Global Alliance is a non-profit association dedicated to improving and extending the lives of people with advanced breast cancer (ABC) worldwide. The Alliance works collaboratively to provide resources, guidance and training opportunities to more than 300 member organisations across the globe, including advocacy groups, HCP organisations, hospitals and other stakeholders. It also lobbies and advocates for the rights of all people living with advanced breast cancer.

ABC Global Alliance hosts the two-yearly ABC International Consensus Conference, where a panel of medical experts and patient advocates develop and update the latest guidelines for the management of ABC, for the benefit of patients everywhere.
The President of ABC Global Alliance and Chair of the ABC International Consensus Conference and Guidelines is Fatima Cardoso, a senior consultant medical oncologist in Lisbon, Portugal. She is recognised globally for her contribution to advances in ABC care.