Kongressbericht zur 44. Jahrestagung der American Society of Clinical Oncology, Chicago 30.5. – 3. 6. 2008

Zusammenfassung

Der diesjährige ASCO stand ganz im Zeichen des Wandels in der onkologischen Therapie weg von reinen Chemotherapiekombinationen hin zur Kombination aus Chemotherapie und zielgerichteten Substanzen. Auffällig war in diesem Jahr die relativ geringe Zahl der Brustkrebsbeiträge. Im Bereich der Neoadjuvanz bestätigten die Ergebnisse der PREPARE-Studie die bessere Wirksamkeit der dosisdichten Konzepte. In der Adjuvanz wurde nicht zuletzt durch die Ergebnisse des tAnGo-Trials deutlich, dass die Hinzunahme einer vierten chemotherapeutischen Substanz nicht zur verbesserten Wirksamkeit und Prognose führt. Die abschließenden Resultate der TBP-Studie und der EGF-104900-Studie belegten die Wirksamkeit von Trastuzumab auch über den Progress hinaus. Im Bereich der gynäkologischen Malignome gab es wenige Beiträge, die eine Änderung des Standards bewirken könnten, dafür aber reichlich neue interessante Ansätze, deren weitere Bearbeitung sehr lohnenswert erscheinen. Hervorzuheben sind hier die Daten der japanischen NOVEL-Studie zur adjuvanten Chemotherapie beim Ovarialkarzinom, die einen Nutzen im krankheitsfreien Überleben und im Gesamtüberleben sahen bei lediglich signifikant mehr Anämien unter der dosisdichten Paclitaxelgabe. Ferner wurden die Daten der PORTEC-2-Studie zur adjuvanten Radiotherapie des Korpuskarzinoms vorgestellt. Bei Endometriumkarzinomen mit höherem Risiko, welche ohne Lymphonodektomie operiert worden waren, zeigten Brachytherapie und externe perkutane Radiatio keine signifikanten Unterschiede im krankheitsfreien und Gesamtüberleben bei deutlich geringerer Nebenwirkungsrate bei der Brachytherapie. Vor allem beim Zervixkarzinom fiel die Vielfalt von bisher noch in Phase-II-Studien eingesetzten zielgerichteten Therapien auf. In der Gesamtschau lässt sich festhalten, dass in diesem Jahr keine Ergebnisse vorgestellt wurden, die zu einer Änderung der Therapiestandards bei gynäkologischen Malignomen führen würden, sondern bestehende Trends bestätigt und neue Konzepte vorgestellt wurden.

Abstract

The recent ASCO was dominated by changes in oncological therapy away from combination chemotherapy to combinations of established cytostatic agents and targeted therapies. The low number of breast cancer reports was noticeable; nevertheless some interesting results were presented. In the neoadjuvant setting, data from the PREPARE trial confirmed the higher efficacy of dose-dense concepts. Regarding adjuvant therapies, results of the tAnGo trial provided proof that inclusion of an additional chemotherapy (Gemcitabine) does not improve efficacy or prognosis. Final data from the TBP and the EGF 104900 trials demonstrated the efficacy of Trastuzumab treatment after progression. In the treatment of gynecological malignancies, there was little that had the potential to change the current standard, but a multitude of new agents and agent combinations were presented. Results of the NOVEL trial showed a benefit with regard to disease-free and overall survival accompanied by higher anemia rates with a dose-dense paclitaxel regimen for the adjuvant treatment of ovarian cancer. The results of the PORTEC 2 endometrium cancer trial were also presented. In higher intermediate risk endometrium cancers without lymphonodectomy there were no significant differences with regard to disease-free and overall survival, but fewer side effects were observed with brachytherapy. A wide range of targeted therapies currently under examination in phase II studies were reported for cervical cancer. In conclusion there were no major changes in state of the art therapies, but existing trends were confirmed and new concepts were presented.

Schlüsselwörter

ASCO - Mammakarzinom - Ovarialkarzinom - Zervixkarzinom - Endometriumkarzinom

Key words

ASCO - breast cancer - ovarian cancer - cervical cancer - endometrial cancer>1–von HS überarbeitet–>

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