Diagnosis and Therapy of Triple-Negative Breast Cancer (TNBC) – Recommendations for Daily Routine Practice

Andreas Schneeweiss; Carsten Denkert; Peter A. Fasching; Carlo Fremd; Oleg Gluz; Cornelia Kolberg-Liedtke; Sibylle Loibl; Hans-Joachim Lück

doi:10.1055/a-0887-0285

Geburtshilfe und Frauenheilkunde, Table of Contents

CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2019; 79(06): 605-617
DOI: 10.1055/a-0887-0285

GebFra Science

Review/Übersicht

Georg Thieme Verlag KG Stuttgart · New York

Diagnostik und Therapie des triple-negativen Mammakarzinoms (TNBC) – Empfehlungen für die tägliche Routine

Article in several languages: English | deutsch

Andreas Schneeweiss

¹Nationales Centrum für Tumorerkrankungen (NCT), Universitätsklinikum, Heidelberg, Germany

²Deutsches Krebsforschungszentrum, Heidelberg, Germany

,

Carsten Denkert

³Institut für Pathologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Marburg, Germany

,

Peter A. Fasching

⁴Frauenklinik des Universitätsklinikums Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany

,

Carlo Fremd

¹Nationales Centrum für Tumorerkrankungen (NCT), Universitätsklinikum, Heidelberg, Germany

,

Oleg Gluz

⁵Brustzentrum Niederrhein, Evangelisches Krankenhaus Bethesda, Mönchengladbach, Germany

⁶Westdeutsche Studiengruppe, Mönchengladbach, Germany

,

Cornelia Kolberg-Liedtke

⁷Charité – Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany

,

Sibylle Loibl

⁸German Breast Group c/o GBG Forschungs GmbH, Neu-Isenburg, Germany

⁹Zentrum für Hämatologie und Onkologie Bethanien, Goethe Universität Frankfurt, Frankfurt am Main, Germany

,

Hans-Joachim Lück

¹⁰Gynäkologie Onkologie, Gynäkologisch-onkologische Praxis, Hannover, Germany

› Author Affiliations

Abstract

Zusammenfassung

Durch den raschen Erkenntnisgewinn zu Tumorbiologie und Tumorpathogenese des triple-negativen Mammakarzinoms (TNBC) ergeben sich neue Therapieansätze und neue Therapiekonzepte für die Behandlung. Seit Jahren gilt das TNBC wegen seiner in der Regel aggressiven Tumorbiologie und angesichts limitierter Therapieoptionen als schwierig zu behandelnder Tumor. Das Rezidiv- und Metastasierungsrisiko ist höher als bei anderen Mammakarzinom-Subtypen desselben Stadiums. Neben Operation und Bestrahlung in der kurativen Situation ist die systemische Chemotherapie mit Anthrazyklinen und/oder Taxanen nach wie vor die Therapie der Wahl. Neue Therapieansätze basieren auf der Erkenntnis, dass das TNBC eine molekular sehr heterogene Erkrankung ist. Forschungsgruppen arbeiten daran, das TNBC immer besser auf molekularer Ebene zu klassifizieren und diese molekulare Subtypisierung als Grundlage für neue therapeutische Strategien zu nutzen. Im Folgenden werden die vielversprechendsten neuen Ansätze und Überlegungen zur Therapie des TNBCs dargestellt. Anhand einer fiktiven Kasuistik werden zudem die derzeitigen Therapiestrategien unter Berücksichtigung der aktuellen Datenlage und den sich daraus ergebenden therapeutischen Konsequenz besprochen.

Schlüsselwörter

triple-negatives Mammakarzinom - BRCA-Mutation - Subtypisierung des TNBC - Diagnostik und Therapie des TNBC

Full Text

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