Update Breast Cancer 2019 Part 5 – Diagnostic and Therapeutic Challenges of New, Personalised Therapies in Patients with Advanced Breast Cancer

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

doi:10.1055/a-1001-9952

Geburtshilfe und Frauenheilkunde, Table of Contents

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 Breast Cancer 2019 Part 5 – Diagnostic and Therapeutic Challenges of New, Personalised Therapies in Patients with Advanced Breast Cancer

Article in several languages: English | deutsch

Authors

Manfred Welslau

¹Onkologie Aschaffenburg, Aschaffenburg, Germany
Andreas D. Hartkopf

²Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
Volkmar Müller

³Department of Gynecology, Hamburg-Eppendorf University Medical Center, Hamburg, Germany
Achim Wöckel

⁴Department of Gynecology and Obstetrics, University Hospital Würzburg, Würzburg, Germany
Michael P. Lux

⁵Kooperatives Brustzentrum Paderborn, Klinik für Gynäkologie und Geburtshilfe Frauenklinik St. Louise, Paderborn, St. Josefs-Krankenhaus, Salzkotten, Germany
Wolfgang Janni

⁶Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
Johannes Ettl

⁷Department of Obstetrics and Gynecology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
Diana Lüftner

⁸Charité University Hospital, Campus Benjamin Franklin, Department of Hematology, Oncology and Tumour Immunology, Berlin, Germany
Erik Belleville

⁹ClinSol GmbH & Co KG, Würzburg, Germany
Florian Schütz

¹⁰Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
Peter A. Fasching

¹¹Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
Hans-Christian Kolberg

¹²Department of Gynecology and Obstetrics, Marienhospital Bottrop, Bottrop, Germany
Naiba Nabieva

¹¹Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
Friedrich Overkamp

¹³OncoConsult Hamburg GmbH, Hamburg, Germany
Florin-Andrei Taran

²Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
Sara Y. Brucker

²Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
Markus Wallwiener

¹⁰Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
Hans Tesch

¹⁴Oncology Practice at Bethanien Hospital Frankfurt, Frankfurt, Germany
Andreas Schneeweiss

¹⁵National Center for Tumor Diseases, Division Gynecologic Oncology, University Hospital Heidelberg, Heidelberg, Germany
Tanja N. Fehm

¹⁶Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Düsseldorf, Germany

Abstract

Significant advancements have been made in recent years in advanced breast cancer and nearly all of them have been in the field of targeted therapy. Pertuzumab and trastuzumab-emtansine (T-DM1) have been able to be introduced in HER2-positive breast cancer. Now other anti-HER2 therapies are being developed (e.g. margetuximab, DS-8201a, pyrotinib) which can overcome other resistance mechanisms in the HER2 signalling pathway. In the field of hormone-receptor-positive breast cancer, an mTOR inhibitor and CDK4/6 inhibitors were introduced in the past. Now the introduction of the first PI3K inhibitor is forthcoming and this inhibitor will involve genetic testing of the tumour for a mutation in the PIK3CA gene. There are also significant advancements in triple-negative breast cancer: By combining chemotherapy and immunotherapy, an advantage for overall survival was able to be demonstrated in a subgroup (immune cells PD-L1-positive). The PARP inhibitor therapy for HER2-negative patients with a germ line mutation in BRCA1 or BRCA2 was also associated with an improved overall survival in a subgroup. These promising new study results are summarised in this review.

Key words

advanced breast cancer - metastases - therapies - mutation testing - immunotherapy

Full Text

References

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