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Senologie - Zeitschrift für Mammadiagnostik und -therapie 2009; 6(1): 25-32
DOI: 10.1055/s-0028-1098839
Wissenschaftliche Arbeit

© Georg Thieme Verlag Stuttgart ˙ New York

Deutsch-Schweizer Experten-Forum San Antonio, 12. Dezember 2008

Neues zur adjuvanten endokrinen Therapie des Mammakarzinoms vom San Antonio Breast Cancer Symposium 2008: Ändern sich die Therapieentscheidungen?German-Swiss Expert Forum San Antonio, 12 December 2008New Findings on Adjuvant Endocrine Therapy of Breast Cancer from San Antonio Breast Cancer Symposium 2008: Are the Therapy Decisions Changing?Mitglieder des Deutsch-Schweizer Expertenforums: J.-U. Blohmer1 , P. Fasching2 , T. Fehm3 , P. Hadji4 , V. Hanf5 , N. Hauser6 , J. Hilfrich7 , J. Huober8 , C. Jackisch9 , F. Jänicke10 , W. Janni11 , W. Jonat12 , R. Kreienberg13 , T. Kühn14 , W. Lichtenegger15 , G. von Minckwitz16 , C. Mundhenke17 , O. Ortmann18 , F. Schütz19 , R. Steiner20 , C. Thomssen21 , D. Wallwiener22
  • 1St. Gertrauden-Krankenhaus, Berlin
  • 2Universitätsklinikum, Erlangen
  • 3Universitätsklinikum, Tübingen
  • 4Klinikum der Philipps-Universität, Marburg
  • 5Klinikum der Stadt Fürth
  • 6Kantonsspital, Baden
  • 7Henriettenstiftung, Hannover
  • 8Brustzentrum, Kantonsspital, St. Gallen
  • 9Klinikum, Offenbach
  • 10Universitätsklinikum Hamburg-Eppendorf
  • 11Universitätsklinikum, Düsseldorf
  • 12Universitätsklinikum Schleswig-Holstein, Kiel
  • 13Universitätsklinikum, Ulm
  • 14Klinikum, Esslingen
  • 15Charité Virchow-Klinikum, Berlin
  • 16GBG Forschungs GmbH, Universitätsfrauenklinik Frankfurt
  • 17Universitätsklinikum Schleswig-Holstein, Kiel
  • 18Universitätsfrauenklinik Regensburg
  • 19Universitätsklinikum, Heidelberg
  • 20Kantonsspital Graubünden, Chur
  • 21Universitätsklinikum, Martin-Luther-Universität, Halle / Saale
  • 22Universitätsfrauenklinik Tübingen
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Publication History

Publication Date:
16 March 2009 (online)

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Zusammenfassung

Im Rahmen des San Antonio Breast Cancer Symposiums (SABCS) haben 22 Experten aus Deutschland und der Schweiz die neuesten Studienergebnisse zur endokrinen adjuvanten Therapie des Mammakarzinoms diskutiert. Kern der Diskus­sion waren die neuen Ergebnisse der Aromatasehemmer-Studien BIG 1-98, ABCSG-8 und TEAM sowie eine Metaanalyse der klinischen Studien zur Upfront-Therapie und zur Sequenztherapie mit Aromatasehemmern. Die in San Antonio vorgestellten neuen Ergebnisse zeigen: Im Bezug auf das fernmetastasenfreie Überleben haben alle Aromatasehemmer gegenüber Tamoxifen einen eindeutigen Vorteil, der in allen vorgestellten Studien nachweislich dokumentiert ist. Jedoch gibt es möglicherweise Patientinnen, bei denen aufgrund von Komorbiditäten eine Entscheidung für Tamoxifen zu überlegen wäre. Zusammen mit der inversen Sequenz (Beginn mit Aromatasehemmer) stehen nunmehr vier Therapieoptionen zur Verfügung. Die in San Antonio 2008 vorgestellten Daten und insbesondere der Überlebensvorteil der BIG 1-98-Studie sprechen für den Beginn mit einem Aromatasehemmer. Zur Frage der optimalen Sequenz können erst weitere zu erwartende Daten endgültig Aufschluss geben.

Abstract

At the San Antonio Breast Cancer Symposium (SABCS) 22 experts from Germany and Switzerland discussed the latest study results of the ­endocrine adjuvant breast cancer therapy. The main focus was on the latest results of the aromatase inhibitor studies BIG 1-98, ABCSG-8 and TEAM as well as a meta-analysis on clinical studies analyzing upfront therapy and sequence therapy with aromatase inhibitors. The new results presented in San Antonio demonstrate: Regarding the distant disease free survival all aromatase ­inhibitors have a clear advantage compared to ­Tamoxifen which is demonstrated in all pre­sent­ed studies. However there are probably patients where a decision for Tamoxifen has to be con­sid­ered because of comorbidities. With the inverse sequence (start with aromatase inhibitor) there are now four therapy options available. The results presented in San Antonio and especially the overall survival demonstrated in the study BIG 1-98 argues for the start with an aromatase inhibitor. Concerning the question of the optimal ­sequence therapy further expected data will give more information finally.

Schlüsselwörter

San Antonio Breast Cancer Symposium - Aromatasehemmer - Mammakarzinom - Brustkrebs - adjuvante endokrine Therapie - BIG 1-98-Studie - ABCSG 8-Studie - TEAM-Studie - Upfront-Therapie - Sequenztherapie

Key words

San Antonio Breast Cancer Symposium - aromatase inhibitor - breast cancer - adjuvant endocrine therapy - BIG 1-98-study - ABCSG 8-study - TEAM-study - upfront therapy - sequence therapy

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Prof. Dr. med. W. Jonat

Klinik für Gynäkologie und Geburtshilfe · Universitätsklinikum Schleswig-Holstein

Michaelisstr. 16

24105 Kiel

Germany

Phone: +49 / 4 31 / 5 97 21 00

Fax: +49 / 4 31 / 5 97 46 40

Email: jonat@email.uni-kiel.de