CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2019; 79(05): 470-482
DOI: 10.1055/a-0887-0861
GebFra Science
Review/Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Update Mammakarzinom 2019 Teil 3 – aktuelle Entwicklungen bei der kurativen Behandlung von Mammakarzinompatientinnen: eine Übersicht und Bewertung durch ein internationales Expertenpanel

Article in several languages: English | deutsch
Hans-Christian Kolberg
1   Department of Gynecology and Obstetrics, Marienhospital Bottrop, Bottrop, Germany
,
Andreas Schneeweiss
2   National Center for Tumor Diseases, Division Gynecologic Oncology, University Hospital and German Cancer Research Center Heidelberg, Heidelberg, Germany
,
Tanja N. Fehm
3   Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Düsseldorf, Germany
,
Achim Wöckel
4   Department of Gynecology and Obstetrics, University Hospital Würzburg, Würzburg, Germany
,
Jens Huober
5   Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
,
Constanza Pontones
6   Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
,
Adriana Titzmann
6   Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
,
Erik Belleville
7   ClinSol GmbH & Co KG, Würzburg, Germany
,
Michael P. Lux
8   Kooperatives Brustzentrum Paderborn, Klinik für Gynäkologie und Geburtshilfe, Frauenklinik St. Louise, Paderborn, St. Josefs-Krankenhaus, Salzkotten, Germany
,
Wolfgang Janni
5   Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
,
Andreas D. Hartkopf
9   Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
,
Florin-Andrei Taran
9   Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
,
Markus Wallwiener
10   Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
,
Friedrich Overkamp
11   OncoConsult Hamburg GmbH, Hamburg, Germany
,
Hans Tesch
12   Oncology Practice at Bethanien Hospital Frankfurt, Frankfurt, Germany
,
Johannes Ettl
13   Department of Obstetrics and Gynecology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
,
Diana Lüftner
14   Charité University Hospital, Campus Benjamin Franklin, Department of Hematology, Oncology and Tumour Immunology, Berlin, Germany
,
Volkmar Müller
15   Department of Gynecology, Hamburg-Eppendorf University Medical Center, Hamburg, Germany
,
Florian Schütz
10   Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
,
Peter A. Fasching
6   Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
,
Sara Y. Brucker
9   Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
› Author Affiliations
Further Information

Publication History

received 01 April 2019

accepted 01 April 2019

Publication Date:
21 May 2019 (online)

Zusammenfassung

Die Behandlung von Mammakarzinompatientinnen in der kurativen Situation ist in vielfacher Hinsicht besonders. Hierbei ist die lokale Therapie mit Operation und Strahlentherapie zentraler Aspekt der Behandlung. Ziel ist eine komplette Elimination aller Tumorzellen am Ort der Primärerkrankung bei gleichzeitigem Bestreben, die Langzeitfolgen so gering wie möglich zu halten. Die immer weitere Reduktion der Radikalität der Lokaltherapie steht auch weiterhin im Blickpunkt. In Bezug auf die Systemtherapie haben sich in den letzten beiden Jahrzehnten Chemotherapien mit Taxanen, Anthrazyklinen und teilweise auch platinhaltigen Chemotherapien etabliert. Der Kontext der Nutzung wird immer genauer definiert. Ebenso gibt es bei der antihormonellen Therapie Fragen, die auch nach Einführung der Aromatasehemmer immer noch weiter definiert werden müssen, wie beispielsweise die Länge der Therapie oder die ovarielle Suppression bei prämenopausalen Patientinnen. Letztendlich soll die Behandlung von frühen Mammakarzinompatientinnen immer personalisierter werden. Prognostische genexpressionistische Tests könnten möglicherweise Therapieentscheidungen unterstützen. Ebenso muss überlegt werden, wie ein möglicher Einsatz von neuen Therapien wie Checkpointinhibitoren und CDK4/6-Inhibitoren in der Praxis aussehen könnten, sobald hier Studienergebnisse vorliegen. Diese Übersichtsarbeit beschäftigt sich mit den Hintergründen zu aktuellen Abstimmungen, die das internationale St.-Gallen-Expertenpanel in Wien 2019 für aktuelle Fragen in der Behandlung von Mammakarzinompatientinnen in der kurativen Situation vorgenommen hat.

Supporting Information

 
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