Biomarkers in Patients with Metastatic Breast Cancer and the PRAEGNANT Study Network

P. A. Fasching; S. Y. Brucker; T. N. Fehm; F. Overkamp; W. Janni; M. Wallwiener; P. Hadji; E. Belleville; L. Häberle; F.-A. Taran; D. Lüftner; M. P. Lux; J. Ettl; V. Müller; H. Tesch; D. Wallwiener; A. Schneeweiss

doi:10.1055/s-0034-1396215

Geburtshilfe und Frauenheilkunde, Inhaltsverzeichnis

Geburtshilfe Frauenheilkd 2015; 75(1): 41-50
DOI: 10.1055/s-0034-1396215

Review

GebFra Science

Georg Thieme Verlag KG Stuttgart · New York

Biomarkers in Patients with Metastatic Breast Cancer and the PRAEGNANT Study Network

Biomarker für Patientinnen mit metastasiertem Mammakarzinom und das PRAEGNANT-Studiennetzwerk

P. A. Fasching^*

¹Frauenklinik des Universitätsklinikums Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen

¹⁷Wissenschaftliche Leitung PRAEGNANT-Studiennetzwerk

,

S. Y. Brucker^*

³Forschungsinstitut für Frauengesundheit, Department für Frauengesundheit, Universitätsklinikum Tübingen, Eberhard Karls Universität Tübingen, Tübingen

¹⁷Wissenschaftliche Leitung PRAEGNANT-Studiennetzwerk

,

T. N. Fehm

⁴Universitäts-Frauenklinik Düsseldorf, Heinrich-Heine Universität Düsseldorf, Düsseldorf

,

F. Overkamp

⁵Oncologianova GmbH Recklinghausen, Recklinghausen

,

W. Janni

⁶Universitätsfrauenklinik Ulm, Ulm

,

M. Wallwiener

⁷Universitätsfrauenklinik Heidelberg, Ruprecht-Karls-Universität Heidelberg, Heidelberg

,

P. Hadji

⁸Krankenhaus Nordwest, Klinik für Gynäkologie und Geburtshilfe, Frankfurt am Main

,

E. Belleville

⁹Clin-Sol GmbH, Würzburg

,

L. Häberle

¹Frauenklinik des Universitätsklinikums Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen

¹⁰Unit of Biostatistics, Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen

,

F.-A. Taran

²Universitäts-Frauenklinik, Department für Frauengesundheit, Universitätsklinikum Tübingen, Eberhard Karls Universität Tübingen, Tübingen

,

D. Lüftner

¹¹Medizinische Klinik mit Schwerpunkt Hämatologie und Onkologie; Charité Campus Benjamin Franklin Berlin, Berlin

,

M. P. Lux

¹Frauenklinik des Universitätsklinikums Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen

,

J. Ettl

¹²Abteilung Gynäkologie und Geburtshilfe, Klinikum rechts der Isar, Technische Universität München, Munich

,

V. Müller

¹³Klinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg

,

H. Tesch

¹⁴Onkologie Bethanien, Frankfurt am Main

¹⁵Studienleitung PRAEGNANT-Studie

,

D. Wallwiener

²Universitäts-Frauenklinik, Department für Frauengesundheit, Universitätsklinikum Tübingen, Eberhard Karls Universität Tübingen, Tübingen

¹⁵Studienleitung PRAEGNANT-Studie

,

A. Schneeweiss

⁶Universitätsfrauenklinik Ulm, Ulm

¹⁶Nationales Centrum für Tumorerkrankungen, Heidelberg

› Institutsangaben

Abstract

Progress has been made in the treatment of metastatic breast cancer in recent decades, but very few therapies use patient or tumor-specific characteristics to tailor individualized treatment. More than ten years after the publication of the reference human genome sequence, analysis methods have improved enormously, fostering the hope that biomarkers can be used to individualize therapies and offer precise treatment based on tumor and patient characteristics. Biomarkers at every level of the system (genetics, epigenetics, gene expression, micro-RNA, proteomics and others) can be used for this. This has led to changes in clinical study designs, with drug developments often only focusing on small or very small subgroups of patients and tumors. The screening and registration of patients and their molecular tumor data has therefore become very important for the successful completion of clinical studies. This new form of medicine presents particular challenges for patients and physicians. Even in this new age of genome-wide analysis, the focus should still be on the patientsʼ quality of life. This review summarizes recent developments and describes how the PRAEGNANT study network manages the aforementioned medical challenges and changes to create a professional infrastructure for patients and physicians.

Zusammenfassung

In den letzten Jahrzehnten sind zwar Fortschritte in der Behandlung des metastasierten Mammakarzinoms erzielt worden, jedoch orientieren sich nur wenige Therapien an den individuellen Eigenschaften der Patientin oder der Tumorerkrankung. Mehr als 10 Jahre nach der Veröffentlichung der menschlichen genetischen Sequenz haben sich die Analysemethoden dahingehend verbessert, dass große Hoffnung besteht, die Therapie weiterzuentwickeln und im Sinne einer „Präzisionsmedizin“ individuell für die Patientin und die Tumorerkrankung zu gestalten. Hierbei werden Biomarker auf jeder Ebene der Systembiologie herangezogen (Genetik, Epigenetik, Genexpression, micro-RNA, Proteomics und weitere). Diese Individualisierung hat zu einer neuen Generation von Studien geführt, sodass manche Arzneimittelentwicklungen nur noch für sehr kleine Patientinnen-Subgruppen durchgeführt werden. Die Organisation der Erfassung von Patientinnen und molekularen Tumordaten ist deswegen von besonderer Bedeutung für die erfolgreiche Durchführung von klinischen Studien. Diese neue Form der Medizin stellt eine besondere Herausforderung für Patientinnen und Ärzte dar. Der Erhalt der Lebensqualität sollte auch in diesem neuen Zeitalter der Medizin als zentrales Therapieziel im Fokus stehen. In diesem Übersichtsartikel werden wir die Entwicklungen der letzten Jahre aufzeigen und das PRAEGNANT-Studiennetzwerk vorstellen, welches die oben genannten Probleme und Ziele angeht und eine professionalisierte Infrastruktur hierfür aufbaut.

Key words

breast cancer - metastasis - PRAEGNANT - mutation - biomarker - prognosis

Schlüsselwörter

Brustkrebs - Metastasen - PRAEGNANT - Mutation - Biomarker - Prognose

Volltext

Referenzen

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