Anwendung von Genexpressionssignaturen beim Mammakarzinom

Zusammenfassung

In Erweiterung zu den klinischen und histopathologischen Faktoren konnten die Genexpressionsanalysen des Mammakarzinoms mit teilweise sehr unterschiedlichen Signaturen unser Wissen um die Prognoseabschätzung dieser heterogenen Erkrankung deutlich erweitern. Obwohl die Ergebnisse prospektiv randomisierter Studien noch nicht vorliegen, sind die bisher vorliegenden Daten zur Validierung der Gensignaturen schon sehr beeindruckend. So hat das Expertenpanel der St.-Gallen-Brustkrebskonferenz von 2009 mehrheitlich die Verwendung der Gensignaturen unter bestimmten Umständen empfohlen. Derzeit sollten die Entscheidungen zur weiteren Therapieempfehlung einer an Brustkrebs erkrankten Frau aber weiterhin auf der sorgfältigen und umfassenden Evaluation der klinischen und histopathologischen Daten beruhen. Aber innerhalb von zwei international durchgeführten wissenschaftlichen Studien (für Europa die MINDACT-Studie) kann die Genexpressionsanalyse betroffenen Patientinnen angeboten werden.

Summary

The gene signatures in women with breast cancer have provided substantial means for a better understanding of the heterogeneity of the disease and the stratification of the subsequent adjuvant therapy. However, recommendations for the postoperative therapy in breast cancer should be based on the thorough evaluation and discussion of the traditional clinical and histo-pathological data. Nevertheless, the use of gene signatures in breast cancer was recommended by the expert panel of the St. Gallen breast cancer meeting in 2009, but under defined circumstances. Actually, women should be included in internationally performed studies that test the gene signatures within prospective and randomized studies (for Europe the MINDACT trial)

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