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Senologie - Zeitschrift für Mammadiagnostik und -therapie 2022; 19(02): 175-184
DOI: 10.1055/a-1816-1625
Übersicht

Update Mammakarzinom 2021 Teil 4 – Prävention und frühe Krankheitsstadien

Update Breast Cancer 2021 Part 4 – Prevention and Early Stages
Christoph Thomssen
1   Department of Gynecology, Martin-Luther-University Halle-Wittenberg, Halle (Saale)
,
Tanja N. Fehm
2   Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Düsseldorf
,
Elmar Stickeler
3   Department of Gynecology and Obstetrics, RWTH University Hospital Aachen, Aachen
,
Peter A. Fasching
4   Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen
,
Wolfgang Janni
5   Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm
,
Cornelia Kolberg-Liedtke
6   Department of Gynecology and Obstetrics, University Hospital Essen, Essen
7   palleos healthcare, Wiesbaden
8   Phaon Scientific, Wiesbaden
,
Hans-Christian Kolberg
9   Department of Gynecology and Obstetrics, Marienhospital Bottrop, Bottrop
,
Diana Lüftner
10   Charité University Hospital, Department of Hematology, Oncology and Tumour Immunology, University Medicine Berlin, Berlin
,
Volkmar Müller
11   Department of Gynecology, Hamburg-Eppendorf University Medical Center, Hamburg
,
Florian Schütz
12   Gynäkologie und Geburtshilfe, Diakonissen-Stiftungs-Krankenhaus Speyer, Speyer
,
Erik Belleville
13   ClinSol GmbH & Co. KG, Würzburg
,
Simon Bader
4   Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen
,
Michael Untch
14   Clinic for Gynecology and Obstetrics, Breast Cancer Center, Genecologic Oncology Center, Helios Klinikum Berlin Buch, Berlin
,
Manfred Welslau
15   Onkologie Aschaffenburg, Aschaffenburg
,
Marc Thill
16   Agaplesion Markus Krankenhaus, Department of Gynecology and Gynecological Oncology, Frankfurt am Main
,
Andreas D. Hartkopf
17   Department of Obstetrics and Gynecology, University of Tübingen, Tübingen
,
Hans Tesch
18   Oncology Practice at Bethanien Hospital, Frankfurt am Main
,
Nina Ditsch
19   Department of Gynecology and Obstetrics, University Hospital Augsburg, Augsburg
,
Michael P. Lux
20   Klinik für Gynäkologie und Geburtshilfe, Frauenklinik St. Louise, Paderborn, St. Josefs-Krankenhaus, Salzkotten, St. Vincenz Krankenhaus GmbH, Paderborn
,
Achim Wöckel
21   Department of Gynecology and Obstetrics, University Hospital Würzburg, Würzburg
,
Bahriye Aktas
22   Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Leipzig, Leipzig
,
Andreas Schneeweiss
23   National Center for Tumor Diseases (NCT), Heidelberg University Hospital and German Cancer Research Center, Heidelberg
,
Rachel Würstlein
24   Breast Center, Department of Gynecology and Obstetrics and CCC Munich LMU, LMU University Hospital, Munich
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Zusammenfassung

Im vergangenen Jahr wurden für viele Patientinnen mit Mammakarzinom in frühem Krankheitsstadium neue und effektive Optionen für eine weitere Verbesserung der Behandlungsergebnisse gezeigt. Für Patientinnen mit hormonrezeptorpositiver Erkrankung zeigte sich ein signifikanter Zusatzeffekt durch den Einsatz des CDK4/6-Inhibitors Abemaciclib zusätzlich zur endokrinen adjuvanten Therapie. Bei triple-negativer Erkrankung wurden Daten für 2 Therapieprinzipien gezeigt. Patientinnen mit fortgeschrittener Erkrankung (Stadium 2 und 3) profitieren von dem neoadjuvanten Einsatz des Immuncheckpoint-Inhibitors Pembrolizumab unabhängig von der PD‑L1-Expression in Kombination mit einer Standardchemotherapie. Bei BRCA1- oder BRCA2-Mutation wurde ein eindrucksvoller Benefit durch den Einsatz des PARP-Inhibitors Olaparib gezeigt, wenn die neoadjuvante Therapie nicht zur gewünschten Remission geführt hat. Weitere Daten betreffen translationale Fragestellungen beim HER2-positiven Mammakarzinom sowie neoadjuvante Therapieansätze mit dem oralen SERD Giredestrant und dem PARP-Inhibitor Talazoparib. In dieser Übersichtsarbeit werden die Ergebnisse der wichtigsten Studienergebnisse dieses Jahres vorgestellt und bewertet.

Abstract

This past year has seen new and effective options for further improving treatment outcome in many patients with earlystage breast cancer. Patients with hormone receptor-positive disease benefited significantly from the addition of the CDK4/6 inhibitor abemaciclib to endocrine adjuvant therapy. In triple-negative disease, data were presented for two treatment regimens. Patients with advanced disease (stage 2 and 3) benefit from neoadjuvant treatment with the immune checkpoint inhibitor pembrolizumab in combination with standard chemotherapy, regardless of PD‑L1 expression. When neoadjuvant therapy has failed to achieve the desired remission in BRCA1 and BRCA2 mutations, the administration of the PARP inhibitor olaparib has demonstrated an impressive response. Other data address translational issues in HER2-positive breast cancer and neoadjuvant therapy approaches with the oral SERD giredestrant and the PARP inhibitor talazoparib. This review presents and analyses the findings of this yearʼ s most important study outcomes.

Schlüsselwörter

BRCA (breast cancer associated gene) - Brust - Mamma - Genetik - Her‑2/neu (humaner epidermaler Wachstumsfaktor‑Rezeptor) - Hormonrezeptor - Mammakarzinom

Key words

BRCA (breast cancer associated gene) - breast - genetics - Her‑2/neu (human epidermal growth factor receptor) - hormonal receptor - breast cancer


Publication History

Received: 06 December 2021

Accepted: 18 December 2021

Article published online:
10 June 2022

© 2022. This article was originally published by Thieme as Christoph Thomssen et al., Update Breast Cancer 2021 Part 4 – Prevention and Early Stages. Geburtsh Frauenheilk 2022; 82: 206–215 as an open access article under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. https://creativecommons.org/licenses/by-nc-nd/4.0/

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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