Update Mammakarzinom 2022 Teil 4 – Brustkrebs in fortgeschrittenen Krankheitsstadien

Bahriye Aktas; Tanja N. Fehm; Manfred Welslau; Volkmar Müller; Diana Lüftner; Florian Schütz; Peter A. Fasching; Wolfgang Janni; Christoph Thomssen; Isabell Witzel; Erik Belleville; Michael Untch; Marc Thill; Hans Tesch; Nina Ditsch; Michael P. Lux; Maggie Banys-Paluchowski; Cornelia Kolberg-Liedtke; Andreas D. Hartkopf; Achim Wöckel; Hans-Christian Kolberg; Elmar Stickeler; Nadia Harbeck; Andreas Schneeweiss

doi:10.1055/a-2001-4729

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

Senologie - Zeitschrift für Mammadiagnostik und -therapie 2023; 20(01): 70-80
DOI: 10.1055/a-2001-4729

Übersicht

Update Mammakarzinom 2022 Teil 4 – Brustkrebs in fortgeschrittenen Krankheitsstadien

Update Breast Cancer 2022 Part 4 – Advanced-Stage Breast Cancer

Authors

Bahriye Aktas

¹Department of Gynecology, University of Leipzig Medical Center, Leipzig
Tanja N. Fehm

²Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Düsseldorf
Manfred Welslau

³Onkologie Aschaffenburg, Aschaffenburg
Volkmar Müller

⁴Department of Gynecology, Hamburg-Eppendorf University Medical Center, Hamburg
Diana Lüftner

⁵Immanuel Hospital Märkische Schweiz & Medical University of Brandenburg Theodor-Fontane, Brandenburg, Buckow
Florian Schütz

⁶Gynäkologie und Geburtshilfe, Diakonissen-Stiftungs-Krankenhaus Speyer, Speyer
Peter A. Fasching

⁷Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen
Wolfgang Janni

⁸Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm
Christoph Thomssen

⁹Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle (Saale)
Isabell Witzel

⁴Department of Gynecology, Hamburg-Eppendorf University Medical Center, Hamburg
Erik Belleville

¹⁰ClinSol GmbH & Co KG, Würzburg
Michael Untch

¹¹Clinic for Gynecology and Obstetrics, Breast Cancer Center, Gynecologic Oncology Center, Helios Klinikum Berlin Buch, Berlin
Marc Thill

¹²Agaplesion Markus Krankenhaus, Department of Gynecology and Gynecological Oncology, Frankfurt am Main
Hans Tesch

¹³Oncology Practice at Bethanien Hospital, Frankfurt am Main
Nina Ditsch

¹⁴Department of Gynecology and Obstetrics, University Hospital Augsburg, Augsburg
Michael P. Lux

¹⁵Klinik für Gynäkologie und Geburtshilfe, Frauenklinik St. Louise, Paderborn, St. Josefs-Krankenhaus, Salzkotten, St. Vincenz Krankenhaus GmbH
Maggie Banys-Paluchowski

¹⁶Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck
Cornelia Kolberg-Liedtke

¹⁷Department of Gynecology and Obstetrics, University Hospital Essen, Essen
Andreas D. Hartkopf

⁸Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm
Achim Wöckel

¹⁸Department of Gynecology and Obstetrics, University Hospital Würzburg, Würzburg
Hans-Christian Kolberg

¹⁹Department of Gynecology and Obstetrics, Marienhospital Bottrop, Bottrop
Elmar Stickeler

²⁰Department of Gynecology and Obstetrics, RWTH University Hospital Aachen, Aachen
Nadia Harbeck

²¹Breast Center, Department of Gynecology and Obstetrics and CCC Munich LMU, LMU University Hospital, Munich
Andreas Schneeweiss

²²National Center for Tumor Diseases (NCT), Heidelberg University Hospital and German Cancer Research Center, Heidelberg

Abstract

Zusammenfassung

Für die Behandlung von Patientinnen mit fortgeschrittenem HER2-negativem, hormonrezeptorpositivem Mammakarzinom sind in den letzten Jahren einige Substanzen in die Praxis eingeführt worden. Zusätzlich sind weitere Medikamente in der Entwicklung. Im letzten Jahr sind einige Studien veröffentlicht worden, die entweder einen Vorteil für das progressionsfreie Überleben oder aber auch für das Gesamtüberleben gezeigt haben. Diese Übersichtsarbeit fasst die neuesten Ergebnisse, welche auf aktuellen Kongressen oder in Fachzeitschriften veröffentlicht wurden, zusammen und ordnet sie in den klinischen Behandlungskontext ein. Insbesondere wird auf den Stellenwert einer Therapie mit CDK4/6 Inhibitoren, Trastuzumab-Deruxtecan, Sacituzumab-Govitecan und Capivasertib eingegangen. Für Trastuzumab-Deruxtecan wurde in der Destiny-Breast-04-Studie ein Gesamtüberlebensvorteil bei HER2-negativem Mammakarzinom mit einer niedrigen HER2-Expression (HER2-low expression) berichtet. Ebenso konnte ein Gesamtüberlebensvorteil in der FAKTION-Studie mit Capivasertib verzeichnet werden. Nach dem fehlenden Gesamtüberlebensvorteil für Palbociclib in der 1. Therapielinie stellt sich hier die Frage nach der klinischen Einordnung.

Abstract

For the treatment of patients with advanced HER2-negative hormone receptor-positive breast cancer, several substances have been introduced into practice in recent years. In addition, other drugs are under development. A number of studies have been published over the past year which have shown either an advantage for progression-free survival or for overall survival. This review summarizes the latest results, which have been published at current congresses or in specialist journals, and classifies them in the clinical treatment context. In particular, the importance of therapy with CDK4/6 inhibitors – trastuzumab deruxtecan, sacituzumab govitecan and capivasertib – is discussed. For trastuzumab deruxtecan, an overall survival benefit in HER2-negative breast cancer with low HER2 expression (HER2-low expression) was reported in the Destiny-Breast-04 study. Similarly, there was an overall survival benefit in the FAKTION study with capivasertib. The lack of overall survival benefit for palbociclib in the first line of therapy raises the question of clinical classification.

Schlüsselwörter

fortgeschrittenes Mammakarzinom - Chemotherapie - endokrine Therapie - Antikörper-Medikament-Konjugate

Key words

advanced breast cancer - chemotherapy - endocrine therapy - antibody drug conjugates

Full Text

References

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