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„Targeted therapy“ des Mammakarzinoms

Adjuvante und neoadjuvante Therapie

Targeted therapy in breast cancer

Adjuvant and neoadjuvant treatment

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Der Gynäkologe Aims and scope

Zusammenfassung

In der neoadjuvanten und adjuvanten Therapie des Mammakarzinoms nimmt die zielgerichtete Therapie einen zunehmend größeren Stellenwert ein. Trastuzumab hat für alle Subgruppen der Patientinnen mit Her2-positivem Rezeptorstatus die Prognose wesentlich verbessert und ist derzeit die einzige zielgerichtete Substanz, die für die Adjuvanzsituation zugelassen ist. Als Tyrosinkinasehemmer wirkt sich Lapatinib ebenfalls auf den Her2-Rezeptor aus, es wird als Monosubstanz, in Kombination und Sequenz derzeit in Studien beim frühen Mammakarzinom geprüft. Bevacizumab ist die bereits am weitesten untersuchte Substanz mit Wirkung auf das VEGF-System. Die antiangiogenetische Therapie ist in der metastasierten Situation etabliert und wird derzeit in adjuvanten und neoadjuvanten Therapiedesigns geprüft. Ein Schwerpunkt der klinischen Forschung besteht darin, den Tumor nicht nur morphologisch, sondern molekularbiologisch genauer zu charakterisieren. Auf dieser Basis könnten Patientinnen für bestimmte Therapien gezielt selektiert werden, um so ihre Prognose zu verbessern. Die derzeit laufenden Phase-III-Studien werden hierzu einen wichtigen Beitrag leisten können.

Abstract

Specific goal-oriented therapy is increasingly gaining significance in neoadjuvant and adjuvant breast cancer therapy. For all subgroups of Her2-positive receptor patients trastuzumab provides a substantially improved prognosis and is presently recognised as the only target-oriented substance admitted to adjuvant treatment. Similar to tyrosine kinase inhibitors, lapatinib has an effect on the Her2 receptor and is currently being examined as a monosubstance both in combination and sequence as a part of studies in the early stages of breast cancer. Bevacizumab is already the most extensively examined substance with an affect on the VEGF system. Antiangiogenetic therapy is well-established in the metastasized situation and is currently being examined in adjuvant and neoadjuvant therapy designs. The existing focal point of clinical research is to precisely characterise the tumour not only morphologically but also molecular biologically. Accordingly, patients can be selected for specific therapies in order to improve the prognosis. For these reasons the current phase III studies can be expected to achieve an important contribution to breast cancer therapy.

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Interessenkonflikt

Die korrespondierende Autorin weist auf Beziehungen zu Glaxo Smith Kline und Roche hin.

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Authors and Affiliations

  1. Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Deutschland

    D. Fischer, K. Röder, C. Dittmer, K. Diedrich & M. Thill

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  1. D. Fischer
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  2. K. Röder
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  3. C. Dittmer
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  4. K. Diedrich
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  5. M. Thill
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Correspondence to D. Fischer.

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Fischer, D., Röder, K., Dittmer, C. et al. „Targeted therapy“ des Mammakarzinoms. Gynäkologe 42, 157–163 (2009). https://doi.org/10.1007/s00129-008-2295-5

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  • DOI: https://doi.org/10.1007/s00129-008-2295-5

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