Update Mammakarzinom 2018 (Teil 3) – Genomforschung, individualisierte Medizin und Immuntherapien – mitten in einer neuen Ära: Prävention und Therapie des frühen Mammakarzinoms

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

doi:10.1055/a-0869-8666

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

Senologie - Zeitschrift für Mammadiagnostik und -therapie 2019; 16(01): 23-32
DOI: 10.1055/a-0869-8666

Wissenschaftliche Arbeit

Update Mammakarzinom 2018 (Teil 3) – Genomforschung, individualisierte Medizin und Immuntherapien – mitten in einer neuen Ära: Prävention und Therapie des frühen Mammakarzinoms

Update breast cancer 2018 (part 3) – genomics, individualized medicine and immune therapies – in the middle of a new era: prevention and treatment strategies for early breast cancer

Authors

Achim Wöckel

¹Department of Gynecology and Obstetrics, University Hospital Würzburg
Michael P. Lux

²Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen
Wolfgang Janni

³Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm
Andreas D. Hartkopf

⁴Department of Obstetrics and Gynecology, University of Tübingen, Tübingen
Naiba Nabieva

²Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen
Florin-Andrei Taran

⁴Department of Obstetrics and Gynecology, University of Tübingen, Tübingen
Friedrich Overkamp

⁵OncoConsult Hamburg GmbH, Hamburg
Peyman Hadji

⁶Department of Bone Oncology, Nordwest Hospital, Frankfurt
Hans Tesch

⁷Oncology Practice at Bethanien Hospital Frankfurt, Frankfurt
Johannes Ettl

⁸Department of Obstetrics and Gynecology, Klinikum rechts der Isar, Technical University of Munich, Munich
Diana Lüftner

⁹Charité University Hospital, Berlin, Campus Benjamin Franklin, Department of Hematology, Oncology and Tumour Immunology, Berlin
Volkmar Müller

¹⁰Department of Gynecology, Hamburg-Eppendorf University Medical Center, Hamburg
Manfred Welslau

¹¹Onkologie Aschaffenburg, Hämatolo-Onkologische Schwerpunktpraxis am Klinikum Aschaffenburg, Aschaffenburg
Erik Belleville

¹²ClinSol GmbH & Co KG, Würzburg
Sara Y. Brucker

⁴Department of Obstetrics and Gynecology, University of Tübingen, Tübingen
Florian Schütz

¹³Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg
Peter A. Fasching

²Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen
Tanja N. Fehm

¹⁴Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Düsseldorf
Andreas Schneeweiss

¹³Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg

¹⁵National Center for Tumor Diseases, Division Gynecologic Oncology, University Hospital Heidelberg, Heidelberg
Hans-Christian Kolberg

¹⁶Department of Gynecology and Obstetrics, Marienhospital Bottrop, Bottrop

Abstract

Zusammenfassung

Beim primären, frühen Mammakarzinom zielt die Behandlungsplanung auf ein immer besseres Verständnis der Erkrankung ab. Die Identifikation von Patientinnen mit einer exzellenten Prognose könnte dieser Gruppe helfen, unnötige Therapien zu vermeiden.Weiterhin wird die Planung der Therapie immer weiter auf die Patientin abgestimmt. Das Wissen über Patientinnen, die besonders von einer Chemotherapie profitieren, wächst genauso wie das Wissen um Patientinnen, die von einer Immuntherapie profitieren könnten. Hinsichtlich der Immuntherapien stehen die durchgeführten Studien kurz vor der Publikation. Einzelne kleinere Studien bieten einen ersten Einblick in die Wirksamkeit der Checkpoint-Inhibitoren (Anti-PD1 / PDL1-Therapien). Nicht zuletzt konnte kürzlich eine der größten Brustkrebsstudien aller Zeiten zu Ende geführt werden. Die Anwendung eines Multigentests konnte zeigen, dass er ausreicht, um Patientinnen mit einer so guten Prognose zu identifizieren, dass keine Chemotherapie nötig ist. Dieser Review-Artikel soll die aktuellen Studien zusammenfassen und einen Ausblick der gegenwärtigen Entwicklungen geben.

Abstract

In primary early breast cancer, the aim of treatment planning is to obtain an increasingly better understanding of the disease. The identification of patients with an excellent prognosis could help this group avoid unnecessary treatments. Furthermore, the planning of treatment is becoming increasingly patient-focussed. There is a growing understanding of those patients who benefit particularly from chemotherapy, as well as of those who could benefit from immunotherapy. Studies conducted on immunotherapies will be published shortly. Smaller individual studies offer an initial insight into the efficacy of checkpoint inhibitors (anti-PD1 / PDL1 therapies). Not least, one of the largest breast cancer studies of all times has recently come to an end. The use of a multigene test has shown that it is sufficient to identify patients with such a good prognosis that chemotherapy is unnecessary. This review article is intended to summarise the current studies and give an outlook on current developments.

Schlüsselwörter

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

Key words

breast cancer - treatment - metastases - CDK4/6 - PD1/PDL1 - studies - risk - prevention

Full Text

References

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