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Erhaltungstherapie bei metastasiertem Mammakarzinom

Maintenance therapy of metastatic breast cancer

  • Leitthema
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Der Gynäkologe Aims and scope

Zusammenfassung

Die Erhaltungstherapie beginnt im Anschluss an die Initialtherapie von Patientinnen mit metastasierten gynäkologischen Malignomen. Durch die Erhaltungstherapie kann eine sichere klinische Symptomkontrolle bei metastasierten Erkrankungen nach primärem guten Ansprechen auf die Initialtherapie erzielt werden, und damit lassen sich auch die Lebensqualität und sogar das Überleben positiv beeinflussen. Meistens wird diese Therapie bis zur erneuten Progression der Erkrankung oder bis zum Auftreten nicht mehr tolerierbarer Nebenwirkungen fortgeführt. Bei der Therapie des metastasierten Mammakarzinoms haben sich solche Medikamente wie endokrine Substanzen, CDK4/6-Inhibitoren, Anti-HER2-Substanzen, verschiedene zytostatische Therapeutika „beyond best response“ und Angiogenesehemmer für die Erhaltungstherapie im klinischen Alltag vollständig etabliert. Die Checkpoint-Inhibitoren sind derzeit Gegenstand intensiver klinischer Studien. Besonderen Stellenwert beim ossär metastasierten Mammakarzinom hat auch die antiresorptive Dauertherapie mit osteoprotektiven Substanzen.

Abstract

Maintenance therapy is started after the initial therapy and it is an important element in the treatment of patients with metastatic gynecological tumors. A safe clinical symptom control can be achieved by maintenance therapy in cases of metastatic disease after good primary response to the initial therapy and can also have a positive influence on the quality of life and even on survival. This therapy is mostly continued until renewed progression of the disease or the appearance of intolerable side effects. Drugs, such as endocrine substances, CDK4/6 inhibitors, anti-HER 2 substances in cases of HER 2 positive metastatic breast cancer, various cytostatic therapeutic drugs beyond best response and angiogenesis inhibitors are well-established in the daily clinical routine as maintenance therapy of metastatic breast cancer. Checkpoint inhibitors are currently the subject of intensive clinical studies. The antiresorptive long-term therapy with osteoprotective substances also has a special importance in the therapy of bone metastases in breast cancer.

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Authors and Affiliations

  1. Gynäkologie, Klinikum Bad Trissl, Bad-Trissl-Str. 73, 83080, Oberaudorf, Deutschland

    V. Aivazova-Fuchs & K. Friese

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  1. V. Aivazova-Fuchs
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  2. K. Friese
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Correspondence to V. Aivazova-Fuchs.

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V. Aivazova-Fuchs und K. Friese geben an, dass kein Interessenkonflikt besteht.

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K. Friese, Oberaudorf

M. Kiechle, München

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Aivazova-Fuchs, V., Friese, K. Erhaltungstherapie bei metastasiertem Mammakarzinom. Gynäkologe 50, 312–319 (2017). https://doi.org/10.1007/s00129-017-4072-9

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