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CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2020; 80(06): 588-600
DOI: 10.1055/a-1139-9380
GebFra Science
Review/Übersicht

ABC5 – Internationale Konsensuskonferenz zum fortgeschrittenen Mammakarzinom, Lissabon, 16.11.2019

Deutsche Expertengruppe kommentiert ABC5-Abstimmungsergebnisse Article in several languages: English | deutsch
Michael Untch
1   Klinik für Gynäkologie und Geburtshilfe, Brustzentrum und Gynäkologisch Onkologisches Zentrum, HELIOS Klinikum Berlin Buch, Berlin, Germany
,
Rachel Würstlein
2   Brustzentrum und Comprehensive Cancer Center (CCC) München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universität München (LMU), München, Germany
,
Diana Lüftner
3   Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und Tumorimmunologie, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
,
Renate Haidinger
4   Brustkrebs Deutschland e. V.; patient advocate, Germany
,
Peter A. Fasching
5   Universitätsfrauenklinik Erlangen, Comprehensive Cancer Center (CCC) Erlangen-EMN, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
,
Doris Augustin
6   Mammazentrum Ostbayern, DONAUISAR Klinikum Deggendorf, Deggendorf, Germany
,
Susanne Briest
7   Klinik und Poliklinik für Frauenheilkunde, Universitätsklinikum Leipzig, Leipzig, Germany
,
Johannes Ettl
8   Frauenklinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum rechts der Isar, München, Germany
,
Frank Förster
9   Praxis für Gynäkologie und Geburtshilfe, Gynäkologische Onkologie und Palliativmedizin, Poliklinik gGmbH, Chemnitz, Germany
,
Christian M. Kurbacher
10   Gynäkologie I (Gynäkologische Onkologie), Gynäkologisches Zentrum, Bonn-Friedensplatz, Bonn, Germany
,
Hans-Joachim Lück
11   Schwerpunktpraxis für Hämato-Onkologie, Hannover, Germany
,
Norbert Marschner
12   Gemeinschaftspraxis für interdisziplinäre Onkologie und Hämatologie, Freiburg, Germany
,
Lothar Müller
13   Onkologische Schwerpunktpraxis Leer-Emden-Papenburg, Leer, Emden, Papenburg, Germany
,
Volkmar Müller
14   Universitätsfrauenklinik Hamburg-Eppendorf, Hamburg, Germany
,
Isabel Radke
15   Brustzentrum, Universitätsklinikum Münster, Münster, Germany
,
Eugen Ruckhäberle
16   Frauenklinik, der Heinrich-Heine-Universität, Düsseldorf, Germany
,
Iris Scheffen
17   Brustzentrum am St. Elisabeth-Krankenhaus GmbH, Köln, Germany
,
Eva Schumacher-Wulf
18   Mamma Mia! Brustkrebs-Magazin, Kronberg, Germany
,
Moritz Schwoerer
19   Frauenklinik, Klinikum Fürstenfeldbruck, Fürstenfeldbruck, Germany
,
Dieter Steinfeld-Birg
20   Gynäkologische Onkologie Augsburg, Augsburg, Germany
,
Katja Ziegler-Löhr
21   Schwerpunktpraxis für gynäkologische Onkologie, Köln, Köln, Germany
,
Christoph Thomssen
22   Universitätsklinik und Poliklinik für Gynäkologie, Martin-Luther-Universität, Halle an der Saale; ABC panel member, ABC scientific committee member, Germany
,
Nadia Harbeck
23   Brustzentrum und Comprehensive Cancer Center (CCC) München, Universität München (LMU), München; ABC panel member, Germany
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Zusammenfassung

Vom 14. bis 16. November 2019 fand in Lissabon die fünfte internationale Konsensuskonferenz ABC5 (Advanced Breast Cancer Fifth Consensus) zu Diagnostik und Behandlung des fortgeschrittenen Mammakarzinoms statt. Ziel ist es, die Behandlung der Patientinnen mit fortgeschrittenem Mammakarzinom weltweit auf evidenzbasierter Grundlage zu standardisieren und sicherzustellen, dass Patientinnen überall auf der Welt adäquat behandelt werden und Zugang zu neuen Therapien erhalten. Ein inhaltlicher Schwerpunkt lag dieses Jahr auf neuen Entwicklungen und Studienergebnissen beim fortgeschrittenen Mammakarzinom sowie der Präzisionsmedizin. Zudem ist die Zusammenarbeit mit den Patientenvertreterinnen aus aller Welt ein wichtiges Anliegen der ABC-Konferenz, weshalb in dem international zusammengesetzten ABC-Panel auch Patientenvertreterinnen sind. Im vorliegenden Manuskript werden die Abstimmungsergebnisse der ABC5-Panelisten vor Ort durch eine Arbeitsgruppe deutscher Brustkrebsexperten für den Therapiealltag in Deutschland kommentiert. Der Kommentierung liegen die Empfehlungen der Arbeitsgemeinschaft gynäkologische Onkologie (AGO), Kommission „Mamma“ zugrunde. Sie erscheint sinnvoll, da in den ABC-Konsensus auch länderspezifische Besonderheiten einfließen.

Schlüsselwörter

ABC5-Konsensus - fortgeschrittenes Mammakarzinom - Präzisionsmedizin - Studiendaten 2019

1 Die Stellungnahme der deutschen Expertengruppe basiert auf den Abstimmungsergebnissen der ABC5-Panelisten vor Ort in Lissabon. Das vorliegende Manuskript ist ein Meinungsbild aus der Sicht deutscher Brustkrebs-Experten. Der offizielle ABC5-Konsensus wird an anderer Stelle unter der Autorenschaft der ABC5-Panelisten publiziert.




Publication History

Received: 12 March 2020

Accepted: 16 March 2020

Article published online:
17 June 2020

© .

Georg Thieme Verlag KG
Stuttgart · New York

 

  • References/Literatur

  • 1 AGO State-of-the-Art Empfehlungen Diagnose und Therapie des frühen und fortgeschrittenen Mammakarzinoms. Update. 2020 Online (last access: 04.03.2020): www.ago-online.de
    PubMedSearch in Google Scholar
  • 2 Cardoso F, Senkus E, Costa A. et al. ESO-ESMO 4th international consensus guidelines for advanced breast cancer (ABC 4). Ann Oncol 2018; 29: 1634-1657
    CrossrefPubMedSearch in Google Scholar
  • 3 Harbeck N, Lüftner D, Marschner N. et al. ABC4 Consensus: Assessment by a German Group of Experts. Breast Care (Basel) 2018; 13: 48-58
    CrossrefPubMedSearch in Google Scholar
  • 4 Cardoso F, Costa A, Norton L. et al. 1st International consensus guidelines for advanced breast cancer (ABC 1). Breast 2012; 21: 242-252 doi:10.1016/j.breast.2012.03.003
    CrossrefPubMedSearch in Google Scholar
  • 5 Cardoso F, Costa A, Norton L. et al. ESO-ESMO 2nd international consensus guidelines for advanced breast cancer (ABC2). Breast 2014; 23: 489-502
    CrossrefPubMedSearch in Google Scholar
  • 6 Cardoso F, Costa A, Senkus E. et al. ESO-ESMO 3rd international consensus guidelines for advanced breast cancer (ABC 3). Breast 2017; 31: 244-259
    CrossrefPubMedSearch in Google Scholar
  • 7 Online (last access: 30.11.2019): http://www.esmo.org/Guidelines/ESMO-Guidelines-Methodology
    PubMed
  • 8 Stockler MR, Harvey VJ, Francis PA. et al. Capecitabine Versus Classical Cyclophosphamide, Methotrexate and Fluorouracil As First-Line Chemotherapy for Advanced Breast Cancer. J Clin Oncol 2011; 29: 4498-4504
    CrossrefPubMedSearch in Google Scholar
  • 9 Cazzaniga ME, Biganzoli L, Cortesi L. et al. Metronomic Chemotherapy in Advanced Breast Cancer Study Group. Treating advanced breast cancer with metronomic chemotherapy: what is known, what is new and what is the future?. Onco Targets Ther 2019; 12: 2989-2997
    CrossrefPubMedSearch in Google Scholar
  • 10 Cazzaniga ME, Pinotti G, Montagna E. et al. VICTOR Study Group. Metronomic chemotherapy for advanced breast cancer patients in the real world practice: Final results of the VICTOR-6 study. Breast 2019; 48: 7-16
    CrossrefPubMedSearch in Google Scholar
  • 11 De Iuliis F, Salerno G, Taglieri L. et al. On and off metronomic oral vinorelbine in elderly women with advanced breast cancer. Tumori 2015; 101: 30-35
    CrossrefPubMedSearch in Google Scholar
  • 12 Fedele P, Marino A, Orlando L. et al. Efficacy and safety of low-dose metronomic chemotherapy with capecitabine in heavily pretreated patients with metastatic breast cancer. Eur J Cancer 2012; 48: 24-29
    CrossrefPubMedSearch in Google Scholar
  • 13 Krajnak S, Battista M, Brenner W. et al. Explorative Analysis of Low-Dose Metronomic Chemotherapy with Cyclophosphamide and Methotrexate in a Cohort of Metastatic Breast Cancer Patients. Breast Care (Basel) 2018; 13: 272-276
    CrossrefPubMedSearch in Google Scholar
  • 14 Langkjer ST, Kenholm J, Jensen JD. et al. The NAME trial: a direct comparison of classical oral Navelbine versus Metronomic Navelbine in metastatic breast cancer. Future Oncol 2019; 15: 2561-2569
    CrossrefPubMedSearch in Google Scholar
  • 15 Maur M, Omarini C, Piacentini F. et al. Metronomic Capecitabine Effectively Blocks Leptomeningeal Carcinomatosis From Breast Cancer: A Case Report and Literature Review. Am J Case Rep 2017; 18: 208-211
    CrossrefPubMedSearch in Google Scholar
  • 16 Montagna E, Bagnardi V, Cancello G. et al. Metronomic Chemotherapy for First-Line Treatment of Metastatic Triple-Negative Breast Cancer: A Phase II Trial. Breast Care (Basel) 2018; 13: 177-181
    CrossrefPubMedSearch in Google Scholar
  • 17 Masci G, Losurdo A, Gandini C. et al. Low-dose “metronomic chemotherapy” with oral cyclophosphamide and methotrexate in metastatic breast cancer: a case report of extraordinarily prolonged clinical benefit. Ecancermedicalscience 2012; 6: 275
    PubMedSearch in Google Scholar
  • 18 Gray R, Bhattacharya S, Bowden C. et al. Independent Review of E2100: A Phase III Trial of Bevacizumab Plus Paclitaxel Versus Paclitaxel in Women With Metastatic Breast Cancer. J Clin Oncol 2009; 27: 4966-4972
    CrossrefPubMedSearch in Google Scholar
  • 19 Miller K, Wang M, Gralow J. et al. Paclitaxel plus Bevacizumab versus Paclitaxel Alone for Metastatic Breast Cancer. N Engl J Med 2007; 357: 2666-2676
    CrossrefPubMedSearch in Google Scholar
  • 20 Robert NJ, Diéras V, Glaspy J. et al. RIBBON-1: Randomized, Double-Blind, Placebo-Controlled, Phase III Trial of Chemotherapy With or Without Bevacizumab for First-Line Treatment of Human Epidermal Growth Factor Receptor 2-negative, Locally Recurrent or Metastatic Breast Cancer. J Clin Oncol 2011; 29: 1252-1260
    CrossrefPubMedSearch in Google Scholar
  • 21 Im SA, Lu Y-S, Bardia AB. et al. Overall Survival with Ribociclib plus Endocrine Therapy in Breast Cancer. N Engl J Med 2019; 381: 307-316
    CrossrefPubMedSearch in Google Scholar
  • 22 Slamon D, Neven P, Chia S. et al. Overall survival results of the Phase III MONALEESA-3 trial of postmenopausal patients with hormone receptor-positive human-epidermal growth factor-2-negative advanced breast cancer treated with fulvestrant plus/minus ribociclib. Ann Oncol 2019; 30 (Suppl. 05) v851-v934
    CrossrefPubMedSearch in Google Scholar
  • 23 Online (last access: 30.11.2019): http://www.esmo.org/guidlines/esmo-mcbs
    PubMed
  • 24 Cherny NI, Sullivan R, Dafni U. et al. A standardised, generic, validated approach to stratify the magnitude of clinical benefit that can be anticipated from anti-cancer therapies: the European Society for Medical Oncology Magnitude of Clinical Benefit Scale. Ann Oncol 2015; 26: 1547-1573
    CrossrefPubMedSearch in Google Scholar
  • 25 Cherny NI, Dafni U, Bogaerts J. et al. ESMO Magnitude of Clinical Benefit Scale version 1.1. Ann Oncol 2017; 28: 2340-2366
    CrossrefPubMedSearch in Google Scholar
  • 26 Hartkopf AD, Huober J, Volz B. et al. Treatment landscape of advanced breast cancer patients with hormone receptor positive HER2 negative tumors – Data from the German PRAEGNANT breast cancer registry. Breast 2018; 37: 42-51
    CrossrefPubMedSearch in Google Scholar
  • 27 Endocrine Therapy Plus CDK4/6 in First or Second Line for Hormone (SONIA) Receptor Positive Advanced Breast Cancer. Online (last access: 02.05.2020): https://clinicaltrials.gov/ct2/show/study/NCT03425838
    PubMed
  • 28 André F, Ciruelos E, Rubovszky G. et al. Alpelisib for PIK3CA-mutated, hormone receptor-positive advanced breast cancer. N Engl J Med 2019; 380: 1929-1940
    CrossrefPubMedSearch in Google Scholar
  • 29 Park YH, Kim TY, Kim GM. et al. A randomized phase II study of palbociclib plus exemestane with GNRH agonist versus capecitabine in premenopausal women with hormone receptor-positive metastatic breast cancer (KCSG-BR 15–10, NCT02592746). J Clin Oncol 2019; 37 (Suppl.) Abstr.. 1007
    CrossrefPubMedSearch in Google Scholar
  • 30 Martín M, Zielinski C, Ruíz-Borrego M. et al. Results from PEARL study (GEICAM/2013-02_CECOG/BC.1.3.006): A phase 3 trial of Palbociclib (PAL) in combination with endocrine therapy (ET) versus Capecitabine (CAPE) in hormonal receptor (HR)-positive/human epidermal growth factor receptor (HER) 2-negative metastatic breast cancer (MBC) patients (pts) whose disease progressed on aromatase inhibitors (AIs). San Antonio Breast Cancer Symposium 2019; GS2-07.
    PubMed
  • 31 Mehta RS, Barlow WE, Albain KS. et al. Overall Survival with Fulvestrant plus Anastrozole in Metastatic Breast Cancer. N Engl J Med 2019; 380: 1226-1234
    CrossrefPubMedSearch in Google Scholar
  • 32 Bergh J, Jönsson PE, Lidbrink EK. et al. FACT: an open-label randomized phase III study of fulvestrant and anastrozole in combination compared with anastrozole alone as first-line therapy for patients with receptor-positive postmenopausal breast cancer. J Clin Oncol 2012; 30: 1919-1925
    CrossrefPubMedSearch in Google Scholar
  • 33 Johnston SR, Kilburn LS, Ellis P. et al. SoFEA investigators. Fulvestrant plus anastrozole or placebo versus exemestane alone after progression on non-steroidal aromatase inhibitors in postmenopausal patients with hormone-receptor-positive locally advanced or metastatic breast cancer (SoFEA): a composite, multicentre, phase 3 randomised trial. Lancet Oncol 2013; 14: 989-998
    CrossrefPubMedSearch in Google Scholar
  • 34 Saura C, Oliveira M, Feng YH. Neratinib + capecitabine vs. lapatinib + capecitabine in patients with HER2+ metastatic breast cancer previously treated with ≥ 2 HER2-directed regimens: Findings from the multinational, randomized, phase III NALA trial. JCO ASCO Ann Meeting 2019; #1002.
    PubMed
  • 35 Pivot X, Manikhas A, Zurawski B. et al. CEREBEL (EGF111438): A Phase III, Randomized, Open-Label Study of Lapatinib Plus Capecitabine Versus Trastuzumab Plus Capecitabine in Patients With Human Epidermal Growth Factor Receptor 2-Positive Metastatic Breast Cancer. J Clin Oncol 2015; 33: 1564-1573
    CrossrefPubMedSearch in Google Scholar
  • 36 Schmid P, Adams S, Rugo H. et al. Atezolizumab and nab-Paclitaxel in Advanced Triple-Negative Breast Cancer. N Engl J Med 2019; 379: 2108-2121
    CrossrefPubMedSearch in Google Scholar
  • 37 Cortes J, Lipatov O, Im S. et al. KEYNOTE-119: Phase 3 study of pembrolizumab versus single-agent chemotherapy for metastatic triple-negative breast cancer. Ann Oncol 2019; 30 (Suppl. 05) v851-v934
    CrossrefPubMedSearch in Google Scholar
  • 38 Online (last access: 15.12.2019): http://www.gbg.de/de/studien/brainmet.php
    PubMed
  • 39 Robson M, Im SA, Senkus E. et al. Olaparib for Metastatic Breast Cancer in Patients with a Germline BRCA Mutation. N Engl J Med 2017; 377: 523-533
    CrossrefPubMedSearch in Google Scholar
  • 40 Robson ME, Tung N, Conte P. et al. OlympiAD final overall survival and tolerability results: Olaparib versus chemotherapy treatment of physicianʼs choice in patients with a germline BRCA mutation and HER2-negative metastatic breast cancer. Ann Oncol 2019; 30: 558-566
    CrossrefPubMedSearch in Google Scholar
  • 41 Litton JK, Rugo HS, Ettl J. et al. Talazoparib in Patients with Advanced Breast Cancer and a Germline BRCA Mutation. N Engl J Med 2018; 379: 753-763
    CrossrefPubMedSearch in Google Scholar
  • 42 Lux M, Lewis K, Rider A. et al. BRCA1/2 Testing in HER2- Advanced Breast Cancer (ABC): Results from the European Component of a Multi-Country Real World Study. Ann Oncol 2019; 30 (Suppl. 05) v99-v103 doi:10.1093/annonc/mdz241 .(Poster ESMO 2019)
    CrossrefPubMedSearch in Google Scholar
  • 43 Dieras VC, Han HS, Kaufman B. et al. Phase 3 study of veliparib with carboplatin and paclitaxel in HER2-negative advanced/metastatic gBRCA-associated breast cancer. Ann Oncol 2019; 30 (Suppl. 05) v851-v934
    CrossrefPubMedSearch in Google Scholar
  • 44 ESMO Clinical Practice Guidelines: Supportive and Palliative Care. Online (last access: 30.11.2019): https://www.esmo.org/guidelines/Supportive-and-Palliative-Care
    PubMed
  • 45 Hortobagyi GN, Van Poznak C, Harker WG. et al. Continued Treatment Effect of Zoledronic Acid Dosing Every 12 vs. 4 Weeks in Women With Breast Cancer Metastatic to Bone: The OPTIMIZE-2 Randomized Clinical Trial. JAMA Oncol 2017; 3: 906-912
    CrossrefPubMedSearch in Google Scholar
  • 46 Awan AA, Hutton B, Hilton J. et al. De-escalation of bone-modifying agents in patients with bone metastases from breast cancer: a systematic review and meta-analysis. Breast Cancer Res Treat 2019; 176: 507-517
    CrossrefPubMedSearch in Google Scholar
  • 47 Online (last access: 30.11.2019): http://www.awmf.org; Additionally: S3 Guideline “Early Detection, Diagnostics, Therapy and Follow-up Care in Breast Cancer.” Long Version 4.0. – December 2017. AWMF Registry No. 032–045OL. Online (last access: 30.11.2019): www.leitlinienprogramm-onkologie.de
    PubMed
  • 48 Expanded S3 Guideline on palliative care for patients with incurable cancer. Long Version 2.0 – August 2019. AWMF Registry number: 128/001-OL. Online (last access: 20.01.2020): https://www.dgpalliativmedizin.de/neuigkeiten/august-2019-erweiterte-s3-leitlinie-palliativmedizin.html
    PubMed
  • 49 Dykewicz CA. Summary of the guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. Clin Infect Dis 2001; 33: 139-144
    CrossrefPubMedSearch in Google Scholar