Senologie - Zeitschrift für Mammadiagnostik und -therapie 2018; 15(03): 160-165
DOI: 10.1055/s-0043-124851
Wissenschaftliche Arbeit
© Georg Thieme Verlag KG Stuttgart · New York

Zielgerichtete Therapie des Mammakarzinoms

Current status of targeted treatment in breast cancer Contributor(s):
Katharina Seiffert
,
Barbara Schmalfeldt
,
Volkmar Müller
Further Information

Publication History

Publication Date:
14 September 2018 (online)

Zusammenfassung

Neue Therapieansätze haben die Behandlungsmöglichkeiten des Mammakarzinoms in den letzten Jahren deutlich verbessert. Je nach Subtyp (Hormonrezeptor-positives Mammakarzinom, HER2-positives Mammakarzinom oder triple-negatives Mammakarzinom) können verschiedene zielgerichtete Therapeutika eingesetzt werden. Der folgende Artikel beschreibt die zielgerichtete Therapie des Mammakarzinoms im Frühstadium sowie in der metastasierten Situation.

Abstract

Within the last years, significant improvements have been achieved in breast cancer treatment, particularly with the development of targeted therapies. Major progress has been made in identifying the drivers malignant growth in oestrogen-receptor-positive breast cancer and the mechanisms of resistance to endocrine therapy. This progress has translated into several targeted therapies that enhance the efficacy of endocrine therapy; inhibitors of the cyclin-dependent kinases CDK4 and CDK6 like palbociclib and inhibitors of mTOR substantially improve progression-free survival. For patients with HER2-positive disease the addition of Pertuzumab to Trastuzumab in combination with chemotherapy has been a significant improvement in anti-HER2 therapy in early as well as metastatic breast cancer. Evidence-based further line therapy options in the metastatic setting include T-DM1 and in later lines Lapatinib. For triple negative disease the angiogenesis inhibitor Bevacizumab is approved, which increases progression free survival. Immune checkpoint inhibitors, PARP-inhibitors or anti-androgens represent promising strategies, all of which are currently being evaluated in clinical trials. The development of predictive biomarkers to guide targeted therapies is still the subject of research.