Update Mammakarzinom 2021 Teil 2 – fortgeschrittene Stadien, Langzeitfolgen und Biomarker

Zusammenfassung

In dieser Übersichtsarbeit werden relevante Aspekte kürzlich veröffentlichter Studien zur Behandlung von Brustkrebspatientinnen in fortgeschrittenen Stadien sowie zu Biomarkern beim Mammakarzinom zusammenfassend dargestellt und diskutiert. In den letzten Jahren wurde eine Vielzahl von Medikamenten für alle molekularen Subtypen bis zu Phase-III-Studien entwickelt. In Bezug auf die Immuncheckpoint-Inhibitoren wurde in letzter Zeit für die metastasierte Situation der optimale Chemotherapie-Kombinationspartner diskutiert. Mit oralen Taxanen könnte sich eine neue Art von oralen Chemotherapien etablieren. Die Datenlage zu Biomarkern für die Anwendung der CDK4/6-Inhibitoren wächst, was auch eine Weiterentwicklung für andere molekulare Subtypen bedeuten könnte. Beim HER2 +, metastasierten Mammakarzinom wurden neue Substanzen entwickelt, die auch nach massiver Vorbehandlung und/oder zerebraler Metastasierung noch gute Remissionen zeigen. Ebenso wächst das Wissen um zielgerichtete Therapien mit Antikörper-Wirkstoff-Konjugaten (ADC) gegen Trop-2, die bei triple-negativen Mammakarzinomen (TNBC) eine therapeutische Bereicherung bedeuten könnten. Des Weiteren steht das Verständnis des Fertilitätserhaltes nach einer Brustkrebserkrankung im klinischen Fokus. Hier schaffen gepoolte Analysen einen neuen Einblick.

Abstract

This review summarises and discusses significant aspects of recently published studies on patient treatment in advanced breast cancer and on biomarkers in breast cancer. In recent years, a large number of drugs for all molecular subtypes have been developed up to phase III trials. With regard to immune checkpoint inhibitors in metastasised breast cancer, the recent discussion has centred on the best candidate for combined chemotherapy. The oral taxanes could become a new type of oral chemotherapies. There is a growing body of data on biomarkers for the use of CDK4/6 inhibitors, which could also signify further development for other molecular subtypes. New substances have been developed for metastatic HER2 + breast cancer that still result in good remission even after massive prior treatment and/or cerebral metastasis. Similarly, knowledge is growing about targeted therapies with antibody-drug conjugates (ADC) against Trop-2, which could bolster our therapeutic armoury in triple-negative breast cancer (TNBC). In addition, the clinical focus is on understanding how to maintain fertility after breast cancer treatment. Here, pooled analyses provide new insights.

Schlüsselwörter

fortgeschrittenes Mammakarzinom - Biomarker - Therapie - Prognose

Key words

advanced breast cancer - biomarkers - therapy - prognosis

Publikationsverlauf

Artikel online veröffentlicht:
09. März 2022

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