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DOI: 10.1055/s-2008-1038855
© Georg Thieme Verlag KG Stuttgart · New York
Können wir mehr, als wir wissen? – Die molekulare Therapie des Mammakarzinoms: Was leistet die Translationale Forschung in Deutschland?
Conference on Molecular Basics and Therapeutic Implications in Breast Cancer (COMBATing Breast Cancer, 21./22.11.2008, Frankfurt)More Power than Knowledge? – The Molecular Therapy of Breast Cancer: Prospects of Translational Medicine in GermanyPublication History
eingereicht 3.7.2008
akzeptiert 3.7.2008
Publication Date:
29 August 2008 (online)
![](https://www.thieme-connect.de/media/gebfra/200808/lookinside/thumbnails/10.1055-s-2008-1038855-1.jpg)
Zusammenfassung
In den nächsten Jahren werden beim Mammakarzinom zahlreiche molekulare Substanzen im Rahmen klinischer Studien erprobt werden. Dies gibt Hoffnung auf neue Therapieansätze. Allerdings birgt diese Entwicklung auch Gefahren, die in engem Zusammenhang mit den pathophysiologischen Grundlagen und dem teilweise noch lückenhaften Verständnis hinsichtlich der Wirksamkeit solcher Substanzen stehen. Durch die derzeit noch unzureichende tumorbiologische (molekulare) Klassifikation des Mammakarzinoms, unpräzise Definition des Therapietargets und teilweise fehlende translationale Subprotokollen innerhalb entsprechender klinischer Studien laufen wir Gefahr, zahlreiche, wahrscheinlich effektive Substanzen als unwirksam zu deklarieren, weil sie am falschen oder unzureichend selektionierten Patientenkollektiv evaluiert wurden. Daher ist in Zukunft der enge Schulterschluss von Grundlagenforschung, molekularer Diagnostik und klinischer Anwendung unverzichtbar. Darüber hinaus ist die Auseinandersetzung mit den molekularen Zusammenhängen dieser neuen Therapieansätze Grundlage für den erfolgreichen Einsatz zielgerichteter Substanzen in der Klinik. Dies erscheint umso wichtiger, da sich Therapiedauer (hin zu einer langfristigen Therapie) und Nebenwirkungsspektrum verändern werden. Daher sind regelmäßige Fortbildungsveranstaltungen, die die molekularen Grundlagen des Mammakarzinoms zum Inhalt haben, jetzt und in Zukunft unabdingbar, um den engen Dialog zwischen translationaler Forschung und klinischer Patientenversorgung zu gewährleisten.
Abstract
In breast cancer, numerous molecular therapeutic compounds will be investigated in clinical trials in the near future. This development is promising but carries potential dangers, which are closely linked to our incomplete knowledge of the pathophysiology of breast cancer and fragmentary understanding of the activity of those drugs. The inadequate tumour-biological (molecular) classification of breast cancer, the broad definition of treatment targets and the lack of translational subprotocols within clinical trials is dangerous, since several potentially highly effective targeted drugs may be falsely considered to be ineffective, even though they may be highly effective in appropriately selected patient cohorts. For this reason, it is mandatory in future to create an alliance between basic science, molecular diagnostics, and clinical practice. Moreover, for the successful application of targeted drugs it is crucial to understand the molecular interactions of such compounds. This is of particular importance because treatment durations (including long durations of treatment) and the spectra of side effects can be expected to change substantially. Thus, continuous education about the molecular basics of breast cancer is indispensable – at present and in future – to create a close dialogue between translational research and clinical practice.
Schlüsselwörter
zielgerichtete Therapie - translationale Medizin - klinische Studien - Pharmakoökonomie
Key words
targeted therapy - translational medicine - clinical trials - pharmacoeconomics
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PD Dr. med. Achim Rody
Klinik für Gynäkologie und Geburtshilfe
J. W. Goethe-Universität
Theodor-Stern-Kai 7
60590 Frankfurt
Email: achim.rody@em.uni-frankfurt.de