CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2019; 79(10): 1090-1099
DOI: 10.1055/a-1001-9952
GebFra Science
Review/Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Update Mammakarzinom 2019 Teil 5 – diagnostische und therapeutische Herausforderungen neuer personalisierter Therapien bei Patientinnen mit fortgeschrittenem Mammakarzinom

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

Publication History

received 24 July 2019
revised 04 August 2019

accepted 22 August 2019

Publication Date:
22 October 2019 (online)

Zusammenfassung

Beim fortgeschrittenen Mammakarzinom sind in den letzten Jahren deutliche Fortschritte erzielt worden, diese fast alle auf dem Gebiet der zielgerichteten Therapie. Pertuzumab und Trastuzumab-Emtansin (T-DM1) konnten beim HER2-positiven Mammakarzinom eingeführt werden. Nun sind weitere Anti-HER2-Therapien in der Entwicklung (z. B. Margetuximab, DS-8201a, Pyrotinib), die weitere Resistenzmechanismen im HER2-Signalweg überwinden können. Auf dem Gebiet des hormonrezeptorpositiven Mammakarzinoms wurden in der Vergangenheit ein mTOR-Inhibitor und CDK4/6-Inhibitoren eingeführt. Nun steht die Einführung des ersten PI3K-Inhibitors bevor, die eine genetische Testung des Tumors auf eine Mutation im Gen PIK3CA mit sich bringen wird. Beim tripel-negativen Mammakarzinom gibt es ebenfalls deutliche Fortschritte: Durch Kombination von Chemo- plus Immuntherapie konnte ein Vorteil für das Gesamtüberleben in einer Subgruppe (Immunzellen PD-L1-positiv) gezeigt werden. Die PARP-Inhibitor-Therapie für HER2-negative Patientinnen mit einer Keimbahnmutation in BRCA1 oder BRCA2 war ebenfalls in einer Subgruppe mit einem verbesserten Gesamtüberleben assoziiert. Diese vielversprechenden, neuen Studienergebnisse werden in dieser Übersichtsarbeit zusammengefasst.

 
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