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. 2012 Jul;72(7):602-615.
doi: 10.1055/s-0032-1315131.

Breast Cancer 2012 - New Aspects

Affiliations

Breast Cancer 2012 - New Aspects

H-C Kolberg et al. Geburtshilfe Frauenheilkd. 2012 Jul.

Abstract

Treatment options as well as the characteristics for therapeutic decisions in patients with primary and advanced breast cancer are increasing in number and variety. New targeted therapies in combination with established chemotherapy schemes are broadening the spectrum, however potentially promising combinations do not always achieve a better result. New data from the field of pharmacogenomics point to prognostic and predictive factors that take not only the properties of the tumour but also inherited genetic properties of the patient into consideration. Current therapeutic decision-making is thus based on a combination of classical clinical and modern molecular biomarkers. Also health-economic aspects are more frequently being taken into consideration so that health-economic considerations may also play a part. This review is based on information from the recent annual congresses. The latest of these are the 34th San Antonio Breast Cancer Symposium 2011 and the ASCO Annual Meeting 2012. Among their highlights are the clinically significant results from the CLEOPATRA, BOLERO-2, EMILIA and SWOG S0226 trials on the therapy for metastatic breast cancer as well as further state-of-the-art data on the adjuvant use of bisphosphonates within the framework of the ABCSG-12, ZO-FAST, NSABP-B34 and GAIN trials.

Die Behandlungsoptionen und auch die Charakteristika zur Therapieentscheidung der Patientin mit einem primären und fortgeschrittenen Mammakarzinom werden immer vielfältiger. Neue zielgerichtete Therapien in Kombination mit etablierten Chemotherapien erweitern das Spektrum, doch potenziell vielversprechende Kombinationen bringen nicht immer ein besseres Ergebnis. Neueste Daten aus der Pharmakogenomik weisen auf Prognose- und Prädiktivfaktoren hin, die nicht nur die Eigenschaften des Tumors, sondern auch die vererbbaren genetischen Eigenschaften der Patientin berücksichtigen. Die aktuelle Therapieentscheidung ist somit mittlerweile eine Kombination aus klassischerweise klinischen und modernen molekularen Biomarkern. Immer häufiger werden auch gesundheitsökonomische Aspekte berücksichtigt, sodass auch gesundheitspolitische Überlegungen eine Rolle spielen können. Dieser Übersichtsartikel baut auf den aktuellen Kongressen auf, die jedes Jahr stattfinden. Die letzten berücksichtigten sind hierbei das 34. San Antonio Breast Cancer Symposium und das ASCO Annual Meeting 2012. Zu deren Highlights zählten die klinisch bedeutsamen Ergebnisse der Studien CLEOPATRA, BOLERO-2, EMILIA und SWOG S0226 zur Therapie des metastasierten Mammakarzinoms sowie weitere aktuelle Daten zum adjuvanten Einsatz der Bisphosphonate im Rahmen der Studien ABCSG-12, ZO-FAST, NSABP-B34 und GAIN.

Keywords: ABCSG-12; BOLERO-2; CLEOPATRA; EMILIA; GAIN; NSABP-B34; TDM-1; ZO-FAST; everolimus; pertuzumab.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest This publication was sponsored by Novartis Pharma GmbH. The authors alone are responsible for the content of this publication.

Figures

Fig. 1
Fig. 1
Tryphaena trial – median changes in the left ventricular ejection fraction (LVEF) of the treatment groups A–C (arm A: 3 × FEC + H + P followed by 3 × Doc + H + P; arm B: 3 × FEC followed by Doc + H + P; arm C: 6 × Docetaxel + Carboplatin + H + P) .
Fig. 2
Fig. 2
Comparison of survival according to pathological complete response (pCR) in patients with HER2-postive breast cancer receiving neoadjuvant chemotherapy with and without Trastuzumab compared to patients with HER2-negative tumours .
Fig. 3
Fig. 3
GeparTrio analysis: pCR rate according to subtype and supplemented according to Minckwitz G et al. .
Fig. 4
Fig. 4
CLEOPATRA trial – central, independent evaluation of the primary endpoint progression-free survival (PFS). Modified after Baselga et al. .
Fig. 5
Fig. 5
Progression-free survival in the EMILIA trial. Adapted after Blackwell et al. .
Fig. 6
Fig. 6
SWOG S0226 trial – Evaluation of the primary endpoint progression-free survival. Adapted after Mehta et al. .
Fig. 7
Fig. 7
BOLERO-2 trial – final, central evaluation of the primary endpoint progression-free survival (PFS) after 18 months median follow-up time. Adapted after Piccart et al. .

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