Standard Changing News der Senologie und Gynäkologischen Onkologie

Zusammenfassung

Zahlreiche Studienergebnisse, Kongressbeiträge, Publikationen sowie neue Zulassungen des vergangenen Jahres führen zu neuen therapeutischen Optionen, die die bisherigen Standards in der Therapie der Patientin mit einem Mammakarzinom ändern oder ergänzen. Aufgrund der komplexen Therapielandschaft steht die individuelle Therapiestrategie auf Basis einer interdisziplinären Tumorkonferenz im Fokus. Grundlage ist zunächst die adäquate Diagnostik mit der histologischen Sicherung und Charakterisierung des Tumors. Neue therapeutische Möglichkeiten sind u. a. die CDK4/6-Inhibitoren zur Überwindung der endokrinen Resistenz beim Hormonrezeptor-positiven Mammakarzinom, die Immunoonkologie für das triple-negative Mammakarzinom und die PARP-Inhibitoren für die Subgruppe der BRCA-assoziierten Mammakarzinome. Auch in der gynäkologischen Onkologie verändern sich bestehende therapeutische Standards. Für das Ovarialkarzinom konnten neue Daten zur Wertigkeit der systematischen Lymphonodektomie gezeigt werden, auf die bei speziellen Kriterien zukünftig ggf. ohne Überlebensnachteil verzichtet werden kann. Die Daten der DESKTOP-III-Studie können die Planung der operativen Therapie des Ovarialkarzinomrezidivs individualisieren. Weitere interessante Ansätze gibt es zur medikamentösen Therapie des platinsensitiven Ovarialkarzinomrezidivs. In Bezug auf das Hochrisiko-Endometriumkarzinom wurde die adjuvante Chemotherapie mit Carboplatin und Paclitaxel als Standard bestätigt, und beim metastasierten Zervixkarzinom bietet der PD-L1-Antikörper einen interessanten neuen Ansatzpunkt.

• Literatur

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