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Senologie - Zeitschrift für Mammadiagnostik und -therapie 2020; 17(02): 121-128
DOI: 10.1055/a-1157-3036
Wissenschaftliche Arbeit

Zirkulierende und disseminierte Tumorzellen beim Mammakarzinom

Bericht von der Konsensuskonferenz Tumorzelldissemination im Rahmen der 39. Jahrestagung der Deutschen Gesellschaft für Senologie, Berlin, 27.06.2019Circulating and Disseminated Tumor Cells in Breast CarcinomaReport from the Consensus Conference on Tumor Cell Dissemination during the 39th Annual Meeting of the German Society of Senology, Berlin, 27 June 2019
Malgorzata Banys-Paluchowski
1   Frauenklinik, Asklepios-Klinik Barmbek, Hamburg
,
Tanja Fehm
2   Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Düsseldorf, Düsseldorf
,
Wolfgang Janni
3   Frauenklinik, Universitätsklinikum Ulm, Ulm
,
Erich-Franz Solomayer
4   Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar
,
Andreas Hartkopf
5   Universitäts-Frauenklinik, Universitätsklinikum Tübingen, Tübingen
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Zusammenfassung

Die hämatogene Dissemination vereinzelter Tumorzellen aus dem Primärtumor ist ein weitverbreitetes Phänomen bei den meisten soliden Malignomen. Beim Mammakarzinom weisen zirkulierende Tumorzellen (ZTZ) im peripheren Blut und disseminierte Tumorzellen (DTZ) im Knochenmark auf eine schlechte klinische Prognose hin, sowohl im Frühstadium als auch bei der metastasierten Erkrankung. Darüber hinaus ist der Nachweis von ZTZ/DTZ auch mit kürzeren rezidivfreien Intervallen assoziiert. Zahlreiche Studien haben gezeigt, dass sich diese Zellen hinsichtlich ihres Hormon- und HER2-Rezeptor-Status von den Tumorzellen des Primärtumors unterscheiden, und es wurde die Hypothese aufgestellt, dass einige von ihnen in Wirklichkeit Tumorstammzellen sein könnten. Vor Kurzem wurde anlässlich des 2018 San Antonio Breast Cancer-Symposiums die erste positive Studie über ZTZ-basierende Therapien vorgestellt, die zeigte, dass der Nachweis von ZTZ die Wahl der Behandlungsmethode beim metastasierten HR-positiven HER2-negativen Mammakarzinom beeinflussen kann. In diesem Übersichtsartikel stellen wir den aktuellen Stand zum Nachweis der Tumorzelldissemination vor und diskutieren die Implikationen für künftige Studien.

Abstract

Hematogenous dissemination of single tumor cells from the primary tumor is a common phenomenon in most solid malignancies. In breast cancer, presence of circulating tumor cells (CTCs) in the peripheral blood and disseminated tumor cells (DTCs) in bone marrow predicts poor clinical outcome, both in early and metastatic setting. Beyond that, persistence of CTCs/DTCs is associated with shorter relapse-free interval as well. Numerous studies have shown that these cells differ from tumor cells in the primary tumor with regard to hormone and HER2 receptor status and it has been hypothesized that some of them might be in fact cancer stem cells. Recently, the first positive study on CTC-based therapy interventions has been presented at the San Antonio Breast Cancer Symposium 2018, demonstrating that detection of CTCs may guide treatment decisions in metastatic HR-positive HER2-negative disease. In this review, we present the current state of evidence of tumor cell dissemination and discuss the implications for future trials.

Schlüsselwörter

Tumorzelldissemination - zirkulierende Tumorzellen - disseminierte Tumorzelle - Prognosefaktor - Mammakarzinom

Key words

tumor cell dissemination - circulating tumor cell - disseminated tumor cell - prognostic factor - breast cancer


Publication History

Received: 15 September 2019

Accepted: 18 October 2019

Article published online:
25 June 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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