Abstract
Within the last years, significant improvements have been achieved in breast cancer
treatment, particularly with the development of targeted therapies. Major progress
has been made in identifying the drivers malignant growth in oestrogen-receptor-positive
breast cancer and the mechanisms of resistance to endocrine therapy. This progress
has translated into several targeted therapies that enhance the efficacy of endocrine
therapy; inhibitors of the cyclin-dependent kinases CDK4 and CDK6 like palbociclib
and inhibitors of mTOR substantially improve progression-free survival. For patients
with HER2-positive disease the addition of Pertuzumab to Trastuzumab in combination
with chemotherapy has been a significant improvement in anti-HER2 therapy in early
as well as metastatic breast cancer. Evidence-based further line therapy options in
the metastatic setting include T-DM1 and in later lines Lapatinib. For triple negative
disease the angiogenesis inhibitor Bevacizumab is approved, which increases progression
free survival. Immune checkpoint inhibitors, PARP-inhibitors or anti-androgens represent
promising strategies, all of which are currently being evaluated in clinical trials.
The development of predictive biomarkers to guide targeted therapies is still the
subject of research.
Neue Therapieansätze haben die Behandlungsmöglichkeiten des Mammakarzinoms in den
letzten Jahren deutlich verbessert. Je nach Subtyp (Hormonrezeptor-positives Mammakarzinom,
HER2-positives Mammakarzinom oder triple-negatives Mammakarzinom) können verschiedene
zielgerichtete Therapeutika eingesetzt werden. Der folgende Artikel beschreibt die
zielgerichtete Therapie des Mammakarzinoms im Frühstadium sowie in der metastasierten
Situation.
Schlüsselwörter
Brustkrebs - zielgerichtete Therapie - HER2 - Hormonrezeptor - triple-negativ
Key words
breast cancer - targeted therapy - HER2 - hormone receptor - triple-negative
