CDK4/6-Inhibition: Sequenztherapien und die Suche nach den besten Biomarkern – ein Überblick über die aktuellen Programme

Zusammenfassung

Für Patientinnen wie auch Patienten mit hormonrezeptorpositivem (HRpos)/Human epidermal growth factor receptor 2-negativem (HER2neg) Mammakarzinom wurden in den letzten Jahren einige neue, zielgerichtete Therapien eingeführt. Einige dieser Behandlungen konnten sich nicht nur als neuer Therapiestandard etablieren, sondern führten auch zu einem signifikant verlängerten Gesamtüberleben. Insbesondere die Cyclin-dependent Kinase 4 and 6 Inhibitors (CDK4/6i) haben sich als Therapiestandard in der ersten Therapielinie etabliert. Insgesamt 70 – 80% der Patientinnen werden mit einem CDK4/6i behandelt. Sowohl für die CDK4/6i als auch für die endokrinen Kombinationspartner wurden in den letzten Jahren zunehmend Biomarker beschrieben, die mit einem Progress oder einer klonalen Selektion oder Evolution assoziiert sind. Vor diesem Hintergrund ist die Kenntnis um Effektivitäts- und Resistenzmechanismen von besonderer Bedeutung. Dieses Wissen könnte wegweisend sein, um die effektivsten Sequenzen zu planen und molekulare Grundlagen für das Überwinden der endokrinen Resistenz zu nutzen. Eine der Studien, die mit einer großen Fallzahl dazu beitragen soll, diese Mechanismen zu erforschen, ist die Comprehensive Analysis of sPatial, TempORal and molecular patterns of ribociclib efficacy and resistance in advanced Breast Cancer patients (CAPTOR BC)-Studie. Diese Übersichtsarbeit fasst den aktuellen Stand der klinischen Forschung zur Resistenz gegen endokrine Therapien mit Fokus auf CDK4/6-Inhibitoren zusammen und erörtert aktuelle Studienkonzepte.

Schlüsselwörter

Mammakarzinom - Therapie - CDK4/6

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