Update Mammakarzinom 2019 Teil 1 – Implementierung der Ergebnisse neuer Studienkonzepte beim frühen Mammakarzinom in die klinische Praxis

Andreas D. Hartkopf; Volkmar Müller; Achim Wöckel; Michael P. Lux; Wolfgang Janni; Naiba Nabieva; Florin-Andrei Taran; Johannes Ettl; Diana Lüftner; Erik Belleville; Florian Schütz; Peter A. Fasching; Tanja N. Fehm; Hans-Christian Kolberg; Friedrich Overkamp; Andreas Schneeweiss; Hans Tesch

doi:10.1055/a-0982-9861

TumorDiagnostik & Therapie, Table of Contents

TumorDiagnostik & Therapie 2019; 40(07): 433-444
DOI: 10.1055/a-0982-9861

Thieme Onkologie aktuell

Update Mammakarzinom 2019 Teil 1 – Implementierung der Ergebnisse neuer Studienkonzepte beim frühen Mammakarzinom in die klinische Praxis

Update Breast Cancer 2019 Part 1 – Implementation of Study Results of Novel Study Designs in Clinical Practice in Patients with Early Breast Cancer

Authors

Andreas D. Hartkopf

¹Department of Obstetrics and Gynecology, University of Tübingen, Tübingen
Volkmar Müller

²Department of Gynecology, Hamburg-Eppendorf University Medical Center, Hamburg
Achim Wöckel

³Department of Gynecology and Obstetrics, University-Hospital Würzburg, Würzburg
Michael P. Lux

⁴Erlangen University-Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen
Wolfgang Janni

⁵Department of Gynecology and Obstetrics, Ulm University-Hospital, Ulm
Naiba Nabieva

⁴Erlangen University-Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen
Florin-Andrei Taran

¹Department of Obstetrics and Gynecology, University of Tübingen, Tübingen
Johannes Ettl

⁶Department of Obstetrics and Gynecology, Klinikum rechts der Isar, Technical University of Munich, Munich
Diana Lüftner

⁷Charité University-Hospital, Campus Benjamin Franklin, Department of Hematology, Oncology and Tumour Immunology, Berlin
Erik Belleville

⁸ClinSol GmbH & Co. KG, Würzburg
Florian Schütz

⁹Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg
Peter A. Fasching

⁴Erlangen University-Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen
Tanja N. Fehm

¹⁰Department of Gynecology and Obstetrics, University-Hospital Düsseldorf, Düsseldorf
Hans-Christian Kolberg

¹¹Department of Gynecology and Obstetrics, Marienhospital Bottrop, Bottrop
Friedrich Overkamp

¹²OncoConsult Hamburg GmbH, Hamburg
Andreas Schneeweiss

¹³National Center for Tumor Diseases, Division Gynecologic Oncology, University-Hospital Heidelberg, Heidelberg
Hans Tesch

¹⁴Oncology Practice at Bethanien-Hospital Frankfurt, Frankfurt

Abstract

Zusammenfassung

In der Prävention und Behandlung des frühen Mammakarzinoms sind über die Jahre immer wieder kleine, aber bedeutsame Fortschritte gemacht worden. In der Prävention gewinnen die sogenannten Panel-Gen-Analysen immer mehr an Bedeutung, da das durch die getesteten Gene bedingte Risiko immer besser verstanden wird und somit Konzepte für die Integration in die Krankenversorgung erarbeitet werden können. In der adjuvanten Situation konnte die erste Studie in der sogenannten post-neoadjuvanten Situation bei fehlender pathologischer Komplettremission nach Trastuzumab oder Pertuzumab + Trastuzumab eine deutliche Verbesserung der Prognose zeigen. Weitere Studien mit diesem post-neoadjuvanten Therapiekonzept werden zurzeit noch durchgeführt. Die CDK4/6-Inhibitoren, die in der metastasierten Situation eine deutliche Verbesserung des progressionsfreien Überlebens gezeigt hatten, werden zurzeit in der adjuvanten Situation in großen Therapiestudien getestet. Diese und weitere neue Daten zur Behandlung oder Prävention des primären Mammakarzinoms werden in dieser Übersichtsarbeit vor dem Hintergrund aktueller Studien vorgestellt.

Abstract

For many years, small but significant advancements have been made time and again in the prevention and treatment of early breast cancer. The so-called panel gene analyses are becoming more and more important in prevention, since the risk due to the tested genes is better understood and as a result, concepts for integration in health care can be developed. In the adjuvant situation, the first study in the so-called postneoadjuvant situation was able to demonstrate a clear improvement in the prognosis with an absent pathological complete remission following trastuzumab or pertuzumab + trastuzumab. Additional studies with this post-neoadjuvant therapeutic concept are still being conducted at present. The CDK4/6 inhibitors which had shown a significant improvement in progression-free survival in a metastatic situation are currently being tested in the adjuvant situation in large therapeutic studies. These and other new data for the treatment or prevention of primary breast cancer are presented in this review against the backdrop of current studies.

Schlüsselwörter

frühes Mammakarzinom - adjuvante Therapie - neoadjuvante Therapie - T‑DM1 - Katherine - Prävention

Key words

early breast cancer - adjuvant therapy - neoadjuvant therapy - T‑DM1 - Katherine - prevention

Full Text

References

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