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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   *
1   Frauenklinik des Universitätsklinikums Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen
17   Wissenschaftliche Leitung PRAEGNANT-Studiennetzwerk
,
S. Y. Brucker   *
3   Forschungsinstitut für Frauengesundheit, Department für Frauengesundheit, Universitätsklinikum Tübingen, Eberhard Karls Universität Tübingen, Tübingen
17   Wissenschaftliche Leitung PRAEGNANT-Studiennetzwerk
,
T. N. Fehm
4   Universitäts-Frauenklinik Düsseldorf, Heinrich-Heine Universität Düsseldorf, Düsseldorf
,
F. Overkamp
5   Oncologianova GmbH Recklinghausen, Recklinghausen
,
W. Janni
6   Universitätsfrauenklinik Ulm, Ulm
,
M. Wallwiener
7   Universitätsfrauenklinik Heidelberg, Ruprecht-Karls-Universität Heidelberg, Heidelberg
,
P. Hadji
8   Krankenhaus Nordwest, Klinik für Gynäkologie und Geburtshilfe, Frankfurt am Main
,
E. Belleville
9   Clin-Sol GmbH, Würzburg
,
L. Häberle
1   Frauenklinik des Universitätsklinikums Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen
10   Unit of Biostatistics, Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen
,
F.-A. Taran
2   Universitäts-Frauenklinik, Department für Frauengesundheit, Universitätsklinikum Tübingen, Eberhard Karls Universität Tübingen, Tübingen
,
D. Lüftner
11   Medizinische Klinik mit Schwerpunkt Hämatologie und Onkologie; Charité Campus Benjamin Franklin Berlin, Berlin
,
M. P. Lux
1   Frauenklinik des Universitätsklinikums Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen
,
J. Ettl
12   Abteilung Gynäkologie und Geburtshilfe, Klinikum rechts der Isar, Technische Universität München, Munich
,
V. Müller
13   Klinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
,
H. Tesch
14   Onkologie Bethanien, Frankfurt am Main
15   Studienleitung PRAEGNANT-Studie
,
D. Wallwiener
2   Universitäts-Frauenklinik, Department für Frauengesundheit, Universitätsklinikum Tübingen, Eberhard Karls Universität Tübingen, Tübingen
15   Studienleitung PRAEGNANT-Studie
,
A. Schneeweiss
6   Universitätsfrauenklinik Ulm, Ulm
16   Nationales Centrum für Tumorerkrankungen, Heidelberg
› Author Affiliations
Further Information

Publication History

received 30 December 2014
revised 05 January 2015

accepted 06 January 2015

Publication Date:
05 February 2015 (online)

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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

* Shared lead authorship


Supporting Information

 

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