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Neoadjuvant oder nicht?

Aspekte der Behandlungsplanung nach 20 Jahren neoadjuvanter Therapie

Neoadjuvant or not?

Aspects of treatment planning after 20 years of neoadjuvant therapy

Zusammenfassung

Nach etwa 20 Jahren Erfahrung mit neoadjuvanter Chemotherapie in der Behandlung des Mammakarzinoms (BC) unter Berücksichtigung des „disease free survival“ (DFS) und des „overall survival“ (OS) ist die Datenlage robust. Eine Vielzahl an Studien zeigte den Vorteil einer neoadjuvanten gegenüber einer adjuvanten Chemotherapie. Aus diesem Grund ist die neoadjuvante Therapie, sofern eine Chemotherapie notwendig ist, aktuell der Goldstandard beim Mammakarzinom. Obgleich eine große Palette an neuartigen Systemtherapien zur Verfügung steht, bildet die herkömmliche zytotoxische Therapie immer noch das Rückgrat für HR+/HER2− (high-risk, luminal B), HR+ und HR−/HER2+ und triple-negative (TNBC) Mammakarzinompatientinnen. Der Beitrag fasst die neoadjuvanten Therapieoptionen zusammen und diskutiert wichtige aktuell zur Verfügung stehenden Entscheidungshilfen.

Abstract

Approximately 20 years of structured breast cancer (BC) data analysis on neoadjuvant chemotherapy with regards to disease-free survival (DFS) und overall survival (OS) is available today. A plethora of trials showed the advantage of neoadjuvant vs. adjuvant therapy over the course of time. Therefore, whenever necessary, the administration of chemotherapy preoperatively has become the gold standard in breast cancer therapy today. Despite a multitude of novel drugs and targeted therapy, basic cytotoxic treatment is still mandatory for HR+/HER2− BC (high risk, luminal B), HR+ and HR−/HER2+ BC and triple-negative BC (TNBC). This article will summarize the current standards of neoadjuvant treatment and discuss available decision-making tools and treatment options for neoadjuvant chemotherapy today.

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Author information

Correspondence to Prof. Dr. M. Warm.

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Interessenkonflikt

C. Eichler und M. Warm geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Additional information

Redaktion

N. Maass, Kiel

W. Janni, Ulm

W. Jonat, Kiel

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Eichler, C., Warm, M. Neoadjuvant oder nicht?. Gynäkologe 50, 488–497 (2017). https://doi.org/10.1007/s00129-017-4091-6

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Schlüsselwörter

  • Mammakarzinom
  • Zielgerichtete molekulare Therapie
  • Chemotherapie
  • Biologische Tumormarker
  • Trastuzumab

Keywords

  • Breast cancer
  • Molecular targeted therapy
  • Chemotherapy
  • Biological tumor markers
  • Trastuzumab