Kongressbericht vom 30. Annual San Antonio Breast Cancer Symposium vom 13. - 16. 12. 2007

Zusammenfassung

Das 30. Annual San Antonio Breast Cancer Symposium bestätigte den bereits in den letzten Jahren bestehenden Trend zu einer individualisierten und zielgerichteten Therapie des Mammakarzinoms. Neben der Prävention und der Stammzellforschung waren die wissenschaftlichen Untersuchungen zum HER-Onkogen-Netzwerk sowie die klinische Erprobung bekannter und Entdeckung neuer Biomarker und therapeutischer Substanzen zentrale Themen des Kongresses. Neben neuartigen Ansätzen behalten bewährte Substanzen wie Tamoxifen und die Aromatasehemmer ihre zentrale Bedeutung. Die vorgestellten Daten der Metaanalyse der EBCTCG, aber auch der ATAC und der ATLAS-Studien stellten die Wirksamkeit im Langzeit-Follow-up unter Beweis. Gleichzeitig zeigten die Ergebnisse des 5-Jahre-Follow-ups der ABCSG-12-Knochensubstudie und der Z-FAST-Studie, dass der unter AI auftretenden Abnahme der Knochendichte und Zunahme der Frakturrate mittels Bisphosphonaten wirksam begegnet und vorgebeugt werden kann. In der AI-bedingten Osteopenie scheinen erste Ergebnisse mit Denosumab, einem Antikörper gegen RANK-Ligand, vielversprechend. Zentrale Substanzgruppe in der adjuvanten Chemotherapie bleiben die Taxane. Daten einer Metaanalyse zur Hochdosis-Chemotherapie zeigten keine generelle Überlegenheit eines Verfahrens. Die Ergebnisse der deutschen neoadjuvanten GEPAR-Quattro-Studie belegten für die Subgruppe der lokal fortgeschrittenen Mammakarzinome einen Ansprechvorteil für die sequenzielle und Kombinationstherapie von Docetaxel und Capecitabine nach 4 Zyklen Epirubicin/Cyclophosphamid. Im Her2/neu-positiven Kollektiv erwies sich hier die Trastuzumab-Upfront-Therapie als sicher. Auch in diesem Jahr wurden bewährte Substanzen bestätigt und neue Verfahren, Therapieformen und Substanzen vorgestellt.

Abstract

The 30th Annual San Antonio Breast Cancer Symposium confirmed the general trend towards individualized and targeted therapies of breast cancer in the last years. The main topics of the conference in the areas prevention and stem cell research were investigations into the HER oncogene network and new or established biomarkers and therapeutic drugs. In addition to new approaches, established substances and drugs, e.g. tamoxifen and aromatase inhibitors (AI), have maintained their clinical importance. Data from the EBCTCG trial's meta-analysis was presented, but the ATAC and ATLAS trials also proved their efficacy in the long-term follow-up. At the same time, the 5 year follow-up data of the ABCSG 12 bone study and the Z-FAST trial demonstrated the efficacy of bisphosphonates for the treatment and prevention of AI-related bone loss and fracture rates. First results from the treatment of AI-related osteopenia with Denosumab, an antibody against RANK ligand, have been promising. Taxanes remain the most efficient drug for adjuvant chemotherapy. Data of a meta-analysis comparing high-dose and standard chemotherapy revealed no clear benefit for the high-dose regimens. Results of the neoadjuvant Gepar-Quattro trial demonstrated a good response to sequential or concomitant chemotherapy with docetaxel and capecitabine only for locally advanced breast cancer. In the Her 2 positive subgroup up-front therapy with Trastuzumab was found to be safe. In conclusion, established therapies were confirmed and new diagnostic tools, treatment modalities and drugs were presented.

Schlüsselwörter

Brustkrebs - Chemotherapie - TARGET‐Therapie

Key words

breast cancer - chemotherapy - targeted therapy

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