Schneeweiss Andreas, Bauerfeind Ingo, Fehm Tanja, Janni Wolfgang, Thomssen Christoph, Witzel Isabell, Wöckel Achim, Müller Volkmar
National Center for Tumor Diseases, University Hospital and German Cancer Research Center, Heidelberg, Germany.
Clinic for Gynecology and Obstetrics, Landshut, Germany.
Breast Care (Basel). 2020 Dec;15(6):608-618. doi: 10.1159/000511925. Epub 2020 Nov 2.
In order to offer optimal treatment approaches based on available evidence, the Commission Breast of the Working Group Gynecologic Oncology (AGO) of the German Cancer Society developed therapy algorithms for eight complex treatment situations in primary and advanced breast cancer.
Therapy algorithms for the following complex treatment situations are outlined in this paper: (neo)adjuvant therapy of human epidermal growth factor receptor 2 (HER2)-positive breast cancer; axillary surgery and neoadjuvant chemotherapy; adjuvant endocrine therapy in premenopausal patients; adjuvant endocrine therapy in postmenopausal patients; hormone receptor (HR)-positive/HER2-negative metastatic breast cancer: strategies; HR-positive/HER2-negative metastatic breast cancer: endocrine-based first-line treatment; HER2-positive metastatic breast cancer: first to third-line; metastatic triple-negative breast cancer.
The therapy options shown in these algorithms are based on the current AGO recommendations updated in January 2020 but cannot represent all evidence-based treatment options. Prior therapies, performance status, comorbidities, patient preference, etc. must be taken into account for the actual treatment choice. Therefore, in individual cases, other evidence-based treatment options not listed here may also be appropriate and justified.
为了根据现有证据提供最佳治疗方法,德国癌症协会妇科肿瘤学工作组(AGO)的乳腺癌委员会针对原发性和晚期乳腺癌的八种复杂治疗情况制定了治疗算法。
本文概述了以下复杂治疗情况的治疗算法:人表皮生长因子受体2(HER2)阳性乳腺癌的(新)辅助治疗;腋窝手术和新辅助化疗;绝经前患者的辅助内分泌治疗;绝经后患者的辅助内分泌治疗;激素受体(HR)阳性/HER2阴性转移性乳腺癌:策略;HR阳性/HER2阴性转移性乳腺癌:基于内分泌的一线治疗;HER2阳性转移性乳腺癌:一线至三线治疗;转移性三阴性乳腺癌。
这些算法中显示的治疗选择基于2020年1月更新的AGO当前建议,但不能代表所有循证治疗选择。实际治疗选择必须考虑既往治疗、体能状态、合并症、患者偏好等因素。因此,在个别情况下,此处未列出的其他循证治疗选择也可能是合适且合理的。