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CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2021; 81(06): 654-665
DOI: 10.1055/a-1487-7642
GebFra Science
Review/Übersicht

Update Breast Cancer 2021 Part 3 – Current Developments in the Treatment of Early Breast Cancer: Review and Assessment of Specialised Treatment Scenarios by an International Expert Panel

Article in several languages: English | deutsch
Tanja N. Fehm
1   Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Düsseldorf, Germany
,
Elmar Stickeler
2   Department of Gynecology and Obstetrics, RWTH University Hospital Aachen, Aachen, Germany
,
Peter A. Fasching
3   Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
,
Wolfgang Janni
4   Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
,
Cornelia Kolberg-Liedtke
5   Department of Gynecology and Obstetrics, University Hospital Essen, Essen, Germany
6   palleos healthcare, Wiesbaden, Germany
7   Phaon Scientific, Wiesbaden, Germany
,
Hans-Christian Kolberg
8   Department of Gynecology and Obstetrics, Marienhospital Bottrop, Bottrop, Germany
,
Diana Lüftner
9   Charité University Hospital, Department of Hematology, Oncology and Tumour Immunology, University Medicine Berlin, Berlin, Germany
,
Volkmar Müller
10   Department of Gynecology, Hamburg-Eppendorf University Medical Center, Hamburg, Germany
,
Florian Schütz
11   Gynäkologie und Geburtshilfe, Diakonissen-Stiftungs-Krankenhaus Speyer, Speyer, Germany
,
Christoph Thomssen
12   Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
,
Erik Belleville
13   ClinSol GmbH & Co KG, Würzburg, Germany
,
Annika Behrens
3   Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
,
Simon Bader
3   Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
,
Michael Untch
14   Clinic for Gynecology and Obstetrics, Breast Cancer Center, Genecologic Oncology Center, Helios Klinikum Berlin Buch, Berlin, Germany
,
Manfred Welslau
15   Onkologie Aschaffenburg, Aschaffenburg, Germany
,
Rachel Würstlein
16   Breast Center, Department of Gynecology and Obstetrics and CCC Munich LMU, LMU University Hospital, Munich, Germany
,
Marc Thill
17   Agaplesion Markus Krankenhaus, Department of Gynecology and Gynecological Oncology, Frankfurt, Germany
,
David Krug
18   Department of Radiation Oncology, University Hospital of Schleswig-Holstein, Kiel, Germany
,
Andreas D. Hartkopf
19   Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
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Abstract

The continuous availability of findings from new studies repeatedly results in updated treatment recommendations and guidelines. In the case of breast carcinoma in particular, several studies have been published in the last few years that have transformed how early and advanced breast carcinoma is being treated. However, this by no means means implies that there is agreement among all experts on specific issues. It is precisely the diversity of interpretation of guidelines and study findings that reflects the constantly changing available data and its complexity, as well as the availability of new drugs. In recent years, new substances such as pertuzumab, T-DM1, neratinib and capecitabine have become available to treat patients with early stages of breast carcinoma. Furthermore, the first results on the use of CDK4/6 inhibitors for adjuvant treatment have now been published. Last but not least, the use of multigene tests to avoid the necessity of chemotherapy in certain patients is still under discussion. This review summarises the state of the data and publishes the results of the survey completed by experts at the 2021 St. Gallen Breast Cancer Conference on early-stage breast cancer.

Key words

early breast cancer - therapy decisions - expert panel

Supporting Information

Supporting Information



Publication History

Received: 17 April 2021

Accepted after revision: 20 April 2021

Article published online:
21 June 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References/Literatur

  • 1 Breast Cancer Association Consortium. Dorling L, Carvalho S. et al. Breast Cancer Risk Genes – Association Analysis in More than 113,000 Women. N Engl J Med 2021; 384: 428-439
    CrossrefPubMedSearch in Google Scholar
  • 2 Hu C, Hart SN, Gnanaolivu R. et al. A Population-Based Study of Genes Previously Implicated in Breast Cancer. N Engl J Med 2021; 384: 440-451
    CrossrefPubMedSearch in Google Scholar
  • 3 Couch FJ, Hart SN, Sharma P. et al. Inherited mutations in 17 breast cancer susceptibility genes among a large triple-negative breast cancer cohort unselected for family history of breast cancer. J Clin Oncol 2015; 33: 304-311
    CrossrefPubMedSearch in Google Scholar
  • 4 Fasching PA, Yadav S, Hu C. et al. Mutations in BRCA1/2 and Other Panel Genes in Patients With Metastatic Breast Cancer-Association With Patient and Disease Characteristics and Effect on Prognosis. J Clin Oncol 2021;
    CrossrefPubMedSearch in Google Scholar
  • 5 Shimelis H, LaDuca H, Hu C. et al. Triple-Negative Breast Cancer Risk Genes Identified by Multigene Hereditary Cancer Panel Testing. J Natl Cancer Inst 2018; 110: 855-862
    CrossrefPubMedSearch in Google Scholar
  • 6 Wunderle M, Olmes G, Nabieva N. et al. Risk, Prediction and Prevention of Hereditary Breast Cancer – Large-Scale Genomic Studies in Times of Big and Smart Data. Geburtshilfe Frauenheilkd 2018; 78: 481-492
    Thieme ConnectPubMedSearch in Google Scholar
  • 7 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
  • 8 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
  • 9 AstraZeneca. IDMC has concluded that OlympiA trial of Lynparza crossed superiority boundary for invasive disease-free survival vs. placebo at planned interim analysis. Accessed April 17, 2021 at: https://www.astrazeneca.com/media-centre/press-releases/2021/olympia-trial-of-lynparza-idmc-recommend-early-analysis.html
    PubMed
  • 10 King MT, Link EK, Whelan TJ. et al. Quality of life after breast-conserving therapy and adjuvant radiotherapy for non-low-risk ductal carcinoma in situ (BIG 3-07/TROG 07.01): 2-year results of a randomised, controlled, phase 3 trial. Lancet Oncol 2020; 21: 685-698
    CrossrefPubMedSearch in Google Scholar
  • 11 Chua BH, Link E, Kunkler I. et al. A randomized phase III study of radiation doses and fractionation schedules in non-low risk ductal carcinoma in situ (DCIS) of the breast (BIG 3-07/TROG 07.01). San Antonio Breast Cancer Symposium 2020; 2020: GS2-04
    PubMedSearch in Google Scholar
  • 12 Piltin MA, Hoskin TL, Day CN. et al. Use of the Twelve-Gene Recurrence Score for Ductal Carcinoma in Situ and Its Influence on Receipt of Adjuvant Radiation and Hormonal Therapy. Ann Surg Oncol 2021;
    CrossrefPubMedSearch in Google Scholar
  • 13 Offersen BV, Alsner J, Nielsen HM. et al. Danish Breast Cancer Group Radiation Therapy Committee. Hypofractionated Versus Standard Fractionated Radiotherapy in Patients With Early Breast Cancer or Ductal Carcinoma In Situ in a Randomized Phase III Trial: The DBCG HYPO Trial. J Clin Oncol 2020; 38: 3615-3625
    CrossrefPubMedSearch in Google Scholar
  • 14 Forbes JF, Sestak I, Howell A. et al. Anastrozole versus tamoxifen for the prevention of locoregional and contralateral breast cancer in postmenopausal women with locally excised ductal carcinoma in situ (IBIS-II DCIS): a double-blind, randomised controlled trial. Lancet 2016; 387: 866-873
    CrossrefPubMedSearch in Google Scholar
  • 15 Sestak I, Cuzick J, Bonanni B. et al. 12 year results of anastrozole versus tamoxifen for the prevention of breast cancer in postmenopausal women with locally excised ductal carcinoma in-situ. San Antonio Breast Cancer Symposium 2020; 2020: GS2-02
    PubMedSearch in Google Scholar
  • 16 Brunt AM, Haviland JS, Sydenham M. et al. Ten-Year Results of FAST: A Randomized Controlled Trial of 5-Fraction Whole-Breast Radiotherapy for Early Breast Cancer. J Clin Oncol 2020; 38: 3261-3272
    CrossrefPubMedSearch in Google Scholar
  • 17 Murray Brunt A, Haviland JS, Wheatley DA. et al. FAST-Forward Trial Management Group. Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial. Lancet 2020; 395: 1613-1626
    CrossrefPubMedSearch in Google Scholar
  • 18 Krug D, Baumann R, Combs SE. et al. Breast Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO). Moderate hypofractionation remains the standard of care for whole-breast radiotherapy in breast cancer: Considerations regarding FAST and FAST-Forward. Strahlenther Onkol 2021; 197: 269-280
    CrossrefPubMedSearch in Google Scholar
  • 19 Fastner G, Sedlmayer F, Widder J. et al. Endocrine therapy with or without whole breast irradiation in low-risk breast cancer patients after breast-conserving surgery: 10-year results of the Austrian Breast and Colorectal Cancer Study Group 8A trial. Eur J Cancer 2020; 127: 12-20
    CrossrefPubMedSearch in Google Scholar
  • 20 Hughes KS, Schnaper LA, Bellon JR. et al. Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: long-term follow-up of CALGB 9343. J Clin Oncol 2013; 31: 2382-2387
    CrossrefPubMedSearch in Google Scholar
  • 21 Kunkler IH, Williams LJ, Jack W. et al. Prime 2 randomised trial (postoperative radiotherapy in minimum-risk elderly): Wide local excision and adjuvant hormonal therapy +/− whole breast irradiation in women =/> 65 years with early invasive breast cancer: 10 year results. San Antonio Breast Cancer Symposium 2020; 2020: GS2-03
    PubMedSearch in Google Scholar
  • 22 Ditsch N, Untch M, Kolberg-Liedtke C. et al. AGO Recommendations for the Diagnosis and Treatment of Patients with Locally Advanced and Metastatic Breast Cancer: Update 2020. Breast Care (Basel) 2020; 15: 294-309
    CrossrefPubMedSearch in Google Scholar
  • 23 Poggio F, Bruzzone M, Ceppi M. et al. Platinum-based neoadjuvant chemotherapy in triple-negative breast cancer: a systematic review and meta-analysis. Ann Oncol 2018; 29: 1497-1508
    CrossrefPubMedSearch in Google Scholar
  • 24 Petrelli F, Coinu A, Borgonovo K. et al. The value of platinum agents as neoadjuvant chemotherapy in triple-negative breast cancers: a systematic review and meta-analysis. Breast Cancer Res Treat 2014; 144: 223-232
    CrossrefPubMedSearch in Google Scholar
  • 25 Gass P, Lux MP, Rauh C. et al. Prediction of pathological complete response and prognosis in patients with neoadjuvant treatment for triple-negative breast cancer. BMC Cancer 2018; 18: 1051
    CrossrefPubMedSearch in Google Scholar
  • 26 Loibl S, Weber KE, Timms KM. et al. Survival analysis of carboplatin added to an anthracycline/taxane-based neoadjuvant chemotherapy and HRD score as predictor of response-final results from GeparSixto. Ann Oncol 2018; 29: 2341-2347
    CrossrefPubMedSearch in Google Scholar
  • 27 Hahnen E, Lederer B, Hauke J. et al. Germline Mutation Status, Pathological Complete Response, and Disease-Free Survival in Triple-Negative Breast Cancer: Secondary Analysis of the GeparSixto Randomized Clinical Trial. JAMA Oncol 2017; 3: 1378-1385
    CrossrefPubMedSearch in Google Scholar
  • 28 von Minckwitz G, Schneeweiss A, Loibl S. et al. Neoadjuvant carboplatin in patients with triple-negative and HER2-positive early breast cancer (GeparSixto; GBG 66): a randomised phase 2 trial. Lancet Oncol 2014; 15: 747-756
    CrossrefPubMedSearch in Google Scholar
  • 29 Cortes J, Cescon DW, Rugo HS. et al. KEYNOTE-355 Investigators. Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer (KEYNOTE-355): a randomised, placebo-controlled, double-blind, phase 3 clinical trial. Lancet 2020; 396: 1817-1828
    CrossrefPubMedSearch in Google Scholar
  • 30 Schmid P, Adams S, Rugo HS. et al. IMpassion130 Trial Investigators. Atezolizumab and Nab-Paclitaxel in Advanced Triple-Negative Breast Cancer. N Engl J Med 2018; 379: 2108-2121
    CrossrefPubMedSearch in Google Scholar
  • 31 Mittendorf EA, Zhang H, Barrios CH. et al. Neoadjuvant atezolizumab in combination with sequential nab-paclitaxel and anthracycline-based chemotherapy versus placebo and chemotherapy in patients with early-stage triple-negative breast cancer (IMpassion031): a randomised, double-blind, phase 3 trial. Lancet 2020; 396: 1090-1100
    CrossrefPubMedSearch in Google Scholar
  • 32 Schmid P, Cortes J, Pusztai L. et al. KEYNOTE-522 Investigators. Pembrolizumab for Early Triple-Negative Breast Cancer. N Engl J Med 2020; 382: 810-821
    CrossrefPubMedSearch in Google Scholar
  • 33 Merck and the FDA. Pembrolizumab: Combined FDA and Applicant ODAC Briefing Document for the Oncologic Drugs Advisory Committee (ODAC) Meeting on February 9, 2021. Accessed February 20, 2021 at: https://www.fda.gov/media/145654/download
    PubMed
  • 34 Gianni L, Pienkowski T, Im YH. et al. Efficacy and safety of neoadjuvant pertuzumab and trastuzumab in women with locally advanced, inflammatory, or early HER2-positive breast cancer (NeoSphere): a randomised multicentre, open-label, phase 2 trial. Lancet Oncol 2012; 13: 25-32
    CrossrefPubMedSearch in Google Scholar
  • 35 Gianni L, Pienkowski T, Im YH. et al. 5-year analysis of neoadjuvant pertuzumab and trastuzumab in patients with locally advanced, inflammatory, or early-stage HER2-positive breast cancer (NeoSphere): a multicentre, open-label, phase 2 randomised trial. Lancet Oncol 2016; 17: 791-800
    CrossrefPubMedSearch in Google Scholar
  • 36 Fasching PA, Hartkopf AD, Gass P. et al. Efficacy of neoadjuvant pertuzumab in addition to chemotherapy and trastuzumab in routine clinical treatment of patients with primary breast cancer: a multicentric analysis. Breast Cancer Res Treat 2019; 173: 319-328
    CrossrefPubMedSearch in Google Scholar
  • 37 Schneeweiss A, Chia S, Hickish T. et al. Pertuzumab plus trastuzumab in combination with standard neoadjuvant anthracycline-containing and anthracycline-free chemotherapy regimens in patients with HER2-positive early breast cancer: a randomized phase II cardiac safety study (TRYPHAENA). Ann Oncol 2013; 24: 2278-2284
    CrossrefPubMedSearch in Google Scholar
  • 38 van Ramshorst MS, van der Voort A, van Werkhoven ED. et al. Dutch Breast Cancer Research Group (BOOG). Neoadjuvant chemotherapy with or without anthracyclines in the presence of dual HER2 blockade for HER2-positive breast cancer (TRAIN-2): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 2018; 19: 1630-1640
    CrossrefPubMedSearch in Google Scholar
  • 39 Caudle AS, Yang WT, Krishnamurthy S. et al. Improved Axillary Evaluation Following Neoadjuvant Therapy for Patients With Node-Positive Breast Cancer Using Selective Evaluation of Clipped Nodes: Implementation of Targeted Axillary Dissection. J Clin Oncol 2016; 34: 1072-1078
    CrossrefPubMedSearch in Google Scholar
  • 40 Kuemmel S, Heil J, Rueland A. et al. A Prospective, Multicenter Registry Study to Evaluate the Clinical Feasibility of Targeted Axillary Dissection (TAD) in Node-Positive Breast Cancer Patients. Ann Surg 2020;
    CrossrefPubMedSearch in Google Scholar
  • 41 Banys-Paluchowski M, Gasparri ML, de Boniface J. et al. The Axsana Study Group. Surgical Management of the Axilla in Clinically Node-Positive Breast Cancer Patients Converting to Clinical Node Negativity through Neoadjuvant Chemotherapy: Current Status, Knowledge Gaps, and Rationale for the EUBREAST-03 AXSANA Study. Cancers (Basel) 2021; 13: 1565
    CrossrefPubMedSearch in Google Scholar
  • 42 Cortazar P, Zhang L, Untch M. et al. Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet 2014; 384: 164-172
    CrossrefPubMedSearch in Google Scholar
  • 43 Untch M, Fasching PA, Konecny GE. et al. Pathologic complete response after neoadjuvant chemotherapy plus trastuzumab predicts favorable survival in human epidermal growth factor receptor 2-overexpressing breast cancer: results from the TECHNO trial of the AGO and GBG study groups. J Clin Oncol 2011; 29: 3351-3357
    CrossrefPubMedSearch in Google Scholar
  • 44 Fasching PA, Heusinger K, Haeberle L. et al. Ki67, chemotherapy response, and prognosis in breast cancer patients receiving neoadjuvant treatment. BMC Cancer 2011; 11: 486
    CrossrefPubMedSearch in Google Scholar
  • 45 Huang M, OʼShaughnessy J, Zhao J. et al. Evaluation of Pathologic Complete Response as a Surrogate for Long-Term Survival Outcomes in Triple-Negative Breast Cancer. J Natl Compr Canc Netw 2020; 18: 1096-1104
    CrossrefPubMedSearch in Google Scholar
  • 46 Huang M, OʼShaughnessy J, Zhao J. et al. Association of Pathologic Complete Response with Long-Term Survival Outcomes in Triple-Negative Breast Cancer: A Meta-Analysis. Cancer Res 2020; 80: 5427-5434
    CrossrefPubMedSearch in Google Scholar
  • 47 Masuda N, Lee S-J, Ohtani S. et al. Adjuvant Capecitabine for Breast Cancer after Preoperative Chemotherapy. N Engl J Med 2017; 376: 2147-2159
    CrossrefPubMedSearch in Google Scholar
  • 48 von Minckwitz G, Huang CS, Mano MS. et al. KATHERINE Investigators. Trastuzumab Emtansine for Residual Invasive HER2-Positive Breast Cancer. N Engl J Med 2019; 380: 617-628
    CrossrefPubMedSearch in Google Scholar
  • 49 Mittendorf EA, Vila J, Tucker SL. et al. The Neo-Bioscore Update for Staging Breast Cancer Treated With Neoadjuvant Chemotherapy: Incorporation of Prognostic Biologic Factors Into Staging After Treatment. JAMA Oncol 2016; 2: 929-936
    CrossrefPubMedSearch in Google Scholar
  • 50 Mittendorf EA, Jeruss JS, Tucker SL. et al. Validation of a novel staging system for disease-specific survival in patients with breast cancer treated with neoadjuvant chemotherapy. J Clin Oncol 2011; 29: 1956-1962
    CrossrefPubMedSearch in Google Scholar
  • 51 Fasching PA, Loibl S, Hu C. et al. BRCA1/2 Mutations and Bevacizumab in the Neoadjuvant Treatment of Breast Cancer: Response and Prognosis Results in Patients With Triple-Negative Breast Cancer From the GeparQuinto Study. J Clin Oncol 2018; 36: 2281-2287
    CrossrefPubMedSearch in Google Scholar
  • 52 Paluch-Shimon S, Friedman E, Berger R. et al. Neo-adjuvant doxorubicin and cyclophosphamide followed by paclitaxel in triple-negative breast cancer among BRCA1 mutation carriers and non-carriers. Breast Cancer Res Treat 2016; 157: 157-165
    CrossrefPubMedSearch in Google Scholar
  • 53 Wunderle M, Gass P, Häberle L. et al. BRCA mutations and their influence on pathological complete response and prognosis in a clinical cohort of neoadjuvantly treated breast cancer patients. Breast Cancer Res Treat 2018; 171: 85-94
    CrossrefPubMedSearch in Google Scholar
  • 54 Piccart M, Procter M, Fumagalli D. et al. APHINITY Steering Committee and Investigators. Adjuvant Pertuzumab and Trastuzumab in Early HER2-Positive Breast Cancer in the APHINITY Trial: 6 Yearsʼ Follow-Up. J Clin Oncol 2021;
    CrossrefPubMedSearch in Google Scholar
  • 55 von Minckwitz G, Procter M, de Azambuja E. et al. APHINITY Steering Committee and Investigators. Adjuvant Pertuzumab and Trastuzumab in Early HER2-Positive Breast Cancer. N Engl J Med 2017; 377: 122-131
    CrossrefPubMedSearch in Google Scholar
  • 56 Chan A, Moy B, Mansi J. et al. ExteNET Study Group. Final Efficacy Results of Neratinib in HER2-positive Hormone Receptor-positive Early-stage Breast Cancer From the Phase III ExteNET Trial. Clin Breast Cancer 2021; 21: 80-91.e7
    CrossrefPubMedSearch in Google Scholar
  • 57 Slamon D, Eiermann W, Robert N. et al. Breast Cancer International Research Group. Adjuvant trastuzumab in HER2-positive breast cancer. N Engl J Med 2011; 365: 1273-1283
    CrossrefPubMedSearch in Google Scholar
  • 58 Cameron D, Piccart-Gebhart MJ, Gelber RD. et al. Herceptin Adjuvant (HERA) Trial Study Team. 11 yearsʼ follow-up of trastuzumab after adjuvant chemotherapy in HER2-positive early breast cancer: final analysis of the HERceptin Adjuvant (HERA) trial. Lancet 2017; 389: 1195-1205
    CrossrefPubMedSearch in Google Scholar
  • 59 Perez EA, Romond EH, Suman VJ. et al. Trastuzumab plus adjuvant chemotherapy for human epidermal growth factor receptor 2-positive breast cancer: planned joint analysis of overall survival from NSABP B-31 and NCCTG N9831. J Clin Oncol 2014; 32: 3744-3752
    CrossrefPubMedSearch in Google Scholar
  • 60 Slamon DJ, Eiermann W, Robert NJ. et al. On Behalf of the BCIRG-006 Investigators. Ten year follow-up of BCIRG-006 comparing doxorubicin plus cyclophosphamide followed by docetaxel (AC→T) with doxorubicin plus cyclophosphamide followed by docetaxel and trastuzumab (AC→TH) with docetaxel, carboplatin and trastuzumab (TCH) in HER2+ early breast cancer. Cancer Res 2016; 76 (4 Suppl.) Abstract nr. S5-04
    CrossrefPubMedSearch in Google Scholar
  • 61 Tolaney SM, Guo H, Pernas S. et al. Seven-Year Follow-Up Analysis of Adjuvant Paclitaxel and Trastuzumab Trial for Node-Negative, Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer. J Clin Oncol 2019; 37: 1868-1875
    CrossrefPubMedSearch in Google Scholar
  • 62 Tolaney SM, Barry WT, Dang CT. et al. Adjuvant paclitaxel and trastuzumab for node-negative, HER2-positive breast cancer. N Engl J Med 2015; 372: 134-141
    CrossrefPubMedSearch in Google Scholar
  • 63 Fasching PA, Gass P, Häberle L. et al. Prognostic effect of Ki-67 in common clinical subgroups of patients with HER2-negative, hormone receptor-positive early breast cancer. Breast Cancer Res Treat 2019; 175: 617-625
    CrossrefPubMedSearch in Google Scholar
  • 64 Cheang MC, Chia SK, Voduc D. et al. Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer. J Natl Cancer Inst 2009; 101: 736-750
    CrossrefPubMedSearch in Google Scholar
  • 65 Yerushalmi R, Woods R, Ravdin PM. et al. Ki67 in breast cancer: prognostic and predictive potential. Lancet Oncol 2010; 11: 174-183
    CrossrefPubMedSearch in Google Scholar
  • 66 Nielsen TO, Leung SCY, Rimm DL. et al. Assessment of Ki67 in Breast Cancer: Updated Recommendations from the International Ki67 in Breast Cancer Working Group. J Natl Cancer Inst 2020;
    CrossrefPubMedSearch in Google Scholar
  • 67 Gass P, Untch M, Müller V. et al. Using Probability for Pathological Complete Response (pCR) as a Decision Support Marker for Neoadjuvant Chemotherapy in HER2 Negative Breast Cancer Patients – a Survey Among Physicians. Geburtshilfe Frauenheilkd 2018; 78: 707-714
    Thieme ConnectPubMedSearch in Google Scholar
  • 68 Smith I, Robertson J, Kilburn L. et al. Long-term outcome and prognostic value of Ki67 after perioperative endocrine therapy in postmenopausal women with hormone-sensitive early breast cancer (POETIC): an open-label, multicentre, parallel-group, randomised, phase 3 trial. Lancet Oncol 2020; 21: 1443-1454
    CrossrefPubMedSearch in Google Scholar
  • 69 Nitz U, Gluz O, Kreipe HH. et al. The run-in phase of the prospective WSG-ADAPT HR+/HER2-trial demonstrates the feasibility of a study design combining static and dynamic biomarker assessments for individualized therapy in early breast cancer. Ther Adv Med Oncol 2020; 12
    CrossrefPubMedSearch in Google Scholar
  • 70 Harbeck N, Gluz O, Kuemmel S. et al. West German Study Group. Endocrine therapy alone in patients with intermediate or high-risk luminal early breast cancer (0–3 lymph nodes), Recurrence Score < 26 and Ki67 response after preoperative endocrine therapy: Primary outcome results from the WSG-ADAPT HR+/HER2- trial. San Antonio Breast Cancer Symposium 2020; 2020: GS4-04
    PubMedSearch in Google Scholar
  • 71 Cardoso F, vanʼt Veer LJ, Bogaerts J. et al. MINDACT Investigators. 70-Gene Signature as an Aid to Treatment Decisions in Early-Stage Breast Cancer. N Engl J Med 2016; 375: 717-729
    CrossrefPubMedSearch in Google Scholar
  • 72 Dowsett M, Sestak I, Lopez-Knowles E. et al. Comparison of PAM50 risk of recurrence score with oncotype DX and IHC4 for predicting risk of distant recurrence after endocrine therapy. J Clin Oncol 2013; 31: 2783-2790
    CrossrefPubMedSearch in Google Scholar
  • 73 Sparano JA, Gray RJ, Makower DF. et al. Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer. N Engl J Med 2018; 379: 111-121
    CrossrefPubMedSearch in Google Scholar
  • 74 Denkert C, Loibl S, Noske A. et al. Tumor-associated lymphocytes as an independent predictor of response to neoadjuvant chemotherapy in breast cancer. J Clin Oncol 2010; 28: 105-113
    CrossrefPubMedSearch in Google Scholar
  • 75 Denkert C, von Minckwitz G, Darb-Esfahani S. et al. Tumour-infiltrating lymphocytes and prognosis in different subtypes of breast cancer: a pooled analysis of 3771 patients treated with neoadjuvant therapy. Lancet Oncol 2018; 19: 40-50
    CrossrefPubMedSearch in Google Scholar
  • 76 Würfel F, Erber R, Huebner H. et al. TILGen: A Program to Investigate Immune Targets in Breast Cancer Patients – First Results on the Influence of Tumor-Infiltrating Lymphocytes. Breast Care (Basel) 2018; 13: 8-14
    CrossrefPubMedSearch in Google Scholar
  • 77 Harbeck N, Zhang H, Barrios CH. et al. IMpassion031: Results from a phase III study of neoadjuvant (neoadj) atezolizumab + chemotherapy in early triple-negative breast cancer (TNBC). Ann Oncol 2020; 31 (Suppl. 04) S1142-S1215
    CrossrefPubMedSearch in Google Scholar
  • 78 Allison KH, Hammond MEH, Dowsett M. et al. Estrogen and Progesterone Receptor Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Guideline Update. Arch Pathol Lab Med 2020; 144: 545-563
    CrossrefPubMedSearch in Google Scholar
  • 79 Villegas SL, Nekljudova V, Pfarr N. et al. Therapy response and prognosis of patients with early breast cancer with low positivity for hormone receptors – An analysis of 2765 patients from neoadjuvant clinical trials. Eur J Cancer 2021; 148: 159-170
    CrossrefPubMedSearch in Google Scholar
  • 80 Kommission Mamma der Arbeitsgemeinschaft Gynäkologische Onkologie e.V. in der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe e.V. sowie in der Deutschen Krebsgesellschaft e.V.. Diagnostik und Therapie früher und fortgeschrittener Mammakarzinome. 2021. Accessed April 18, 2021 at: https://www.ago-online.de/fileadmin/ago-online/downloads/_leitlinien/kommission_mamma/2021/Alle_aktuellen_Empfehlungen_2021.pdf
    PubMed
  • 81 Kim HA, Lee JW, Nam SJ. et al. Korean Breast Cancer Study Group. Adding Ovarian Suppression to Tamoxifen for Premenopausal Breast Cancer: A Randomized Phase III Trial. J Clin Oncol 2020; 38: 434-443
    CrossrefPubMedSearch in Google Scholar
  • 82 Pagani O, Francis PA, Fleming GF. et al. SOFT and TEXT Investigators and International Breast Cancer Study Group. Absolute Improvements in Freedom From Distant Recurrence to Tailor Adjuvant Endocrine Therapies for Premenopausal Women: Results From TEXT and SOFT. J Clin Oncol 2020; 38: 1293-1303
    CrossrefPubMedSearch in Google Scholar
  • 83 von Minckwitz G, Graf E, Geberth M. et al. CMF versus goserelin as adjuvant therapy for node-negative, hormone-receptor-positive breast cancer in premenopausal patients: a randomised trial (GABG trial IV-A-93). Eur J Cancer 2006; 42: 1780-1788
    CrossrefPubMedSearch in Google Scholar
  • 84 Schmid P, Untch M, Kossé V. et al. Leuprorelin acetate every-3-months depot versus cyclophosphamide, methotrexate, and fluorouracil as adjuvant treatment in premenopausal patients with node-positive breast cancer: the TABLE study. J Clin Oncol 2007; 25: 2509-2515
    CrossrefPubMedSearch in Google Scholar
  • 85 Sparano JA, Gray RJ, Makower DF. et al. Prospective Validation of a 21-Gene Expression Assay in Breast Cancer. N Engl J Med 2015; 373: 2005-2014
    CrossrefPubMedSearch in Google Scholar
  • 86 Johnston SRD, Harbeck N, Hegg R. et al. monarchE Committee Members and Investigators. Abemaciclib Combined With Endocrine Therapy for the Adjuvant Treatment of HR+, HER2-, Node-Positive, High-Risk, Early Breast Cancer (monarchE). J Clin Oncol 2020; 38: 3987-3998
    CrossrefPubMedSearch in Google Scholar