Update Mammakarzinom 2018 (Teil 2) – Fortgeschrittenes Mammakarzinom, Lebensqualität und Prävention

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

doi:10.1055/s-0043-124850

Senologie - Zeitschrift für Mammadiagnostik und -therapie, Table of Contents

Senologie - Zeitschrift für Mammadiagnostik und -therapie 2018; 15(02): 95-108
DOI: 10.1055/s-0043-124850

Wissenschaftliche Arbeit

Georg Thieme Verlag KG Stuttgart · New York

Update Mammakarzinom 2018 (Teil 2) – Fortgeschrittenes Mammakarzinom, Lebensqualität und Prävention

Update Breast Cancer 2018 (Part 2) – Advanced Breast Cancer, Quality of Life and Prevention

Authors

Andreas Schneeweiss

¹National Center for Tumor Diseases, Division Gynecologic Oncology, University Hospital Heidelberg, Heidelberg

²Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg
Michael P. Lux

³Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen
Wolfgang Janni

⁴Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm
Andreas D. Hartkopf

⁵Department of Obstetrics and Gynecology, University of Tübingen, Tübingen
Naiba Nabieva

³Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen
Florin-Andrei Taran

⁵Department of Obstetrics and Gynecology, University of Tübingen, Tübingen
Friedrich Overkamp

⁶OncoConsult Hamburg GmbH, Hamburg
Hans-Christian Kolberg

⁷Department of Gynecology and Obstetrics, Marienhospital Bottrop, Bottrop
Peyman Hadji

⁸Department of Bone Oncology, Nordwest Hospital, Frankfurt
Hans Tesch

⁹Oncology Practice at Bethanien Hospital Frankfurt, Frankfurt
Achim Wöckel

¹⁰Department of Gynecology and Obstetrics, University Hospital Würzburg, Würzburg
Johannes Ettl

¹¹Department of Obstetrics and Gynecology, Klinikum rechts der Isar, Technical University of Munich, Munich
Diana Lüftner

¹²Charité University Hospital, Berlin, Campus Benjamin Franklin, Department of Hematology, Oncology and Tumour Immunology, Berlin
Markus Wallwiener

²Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg
Volkmar Müller

¹³Department of Gynecology, Hamburg-Eppendorf University Medical Center, Hamburg
Matthias W. Beckmann

³Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen
Erik Belleville

¹⁴ClinSol GmbH & Co KG, Würzburg
Diethelm Wallwiener

⁵Department of Obstetrics and Gynecology, University of Tübingen, Tübingen
Sara Y. Brucker

⁵Department of Obstetrics and Gynecology, University of Tübingen, Tübingen
Florian Schütz

²Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg
Peter A. Fasching

³Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen
Tanja N. Fehm

¹⁵Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Düsseldorf

Abstract

Zusammenfassung

Die Behandlung des metastasierten Mammakarzinoms hat bei immer neu zu testenden Therapien deutlich an Komplexität zugenommen. Therapien werden nunmehr nur noch für spezielle klinische oder molekulare Subgruppen entwickelt. Hierbei spielen die intrinsischen, molekularen Subtypen zwar immer noch die größte Rolle, jedoch gibt es zunehmend auch Therapien, die subgruppen- oder sogar histologieübergreifend entwickelt werden, wie z. B. der PARP-Inhibitor bei BRCA-mutierten Patientinnen (Mamma- und Ovarialkarzinom). Aber auch Supportivtherapien entwickeln sich weiter, sodass Probleme wie die Alopezie besser behandelt werden können und neue Therapiearten von Übelkeit und Erbrechen etabliert werden. In einem engen Zusammenhang mit den Supportivtherapien stehen die Nebenwirkungen, welche bei Patientinnen mit einem metastasierten Mammakarzinom einen direkten Einfluss auf die Prognose haben. Hier könnten digitale Werkzeuge helfen, um ein besseres Patientinnenmanagement zu etablieren. Diese Übersichtsarbeit soll diese Aspekte vor dem Hintergrund neuer, aktuell publizierter Studien beleuchten und einen Einblick geben, wie sich diese Studien zu etablierten Routinetherapien verhalten. Zusätzlich werden aktuelle Aspekte der Mammakarzinomprävention beleuchtet.

Abstract

The treatment of metastatic breast cancer has become more complicated due to increasing numbers of new therapies which need to be tested. Therapies are now being developed to treat special clinical or molecular subgroups. Even though intrinsic molecular subtypes play a major role, more and more new therapies for subgroups and histological subtypes are being developed, such as the use of PARP inhibitors to treat patients with BRCA mutations (breast and ovarian cancer). Supportive therapies are also evolving, allowing problems such as alopecia or nausea and vomiting to be treated more effectively. Treatment-related side effects have a direct impact on the prognosis of patients with metastatic breast cancer, and supportive therapy can improve compliance. Digital tools could be useful to establish better patient management systems. This overview provides an insight into recent trials and how the findings could affect routine treatment. Current aspects of breast cancer prevention are also presented.

Schlüsselwörter

Mammakarzinom - Behandlung - Metastasen - CDK4/6 - PD1/PDL1 - Studien - Risiko - Prävention

Key words

breast cancer - treatment - metastasis - CDK4/6 - PD1/PDL1 - trials - risk - prevention

Full Text

References

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