Lux Michael P, Schneeweiss Andreas, Hartkopf Andreas D, Müller Volkmar, Janni Wolfgang, Belleville Erik, Stickeler Elmar, Thill Marc, Fasching Peter A, Kolberg Hans-Christian, Untch Michael, Harbeck Nadia, Wöckel Achim, Thomssen Christoph, Schulmeyer Carla E, Welslau Manfred, Overkamp Friedrich, Schütz Florian, Lüftner Diana, Ditsch Nina
Klinik für Gynäkologie und Geburtshilfe, Frauenklinik St. Louise, Paderborn, St. Josefs-Krankenhaus, Salzkotten, Germany.
National Center for Tumor Diseases, University Hospital and German Cancer Research Center, Heidelberg, Germany.
Geburtshilfe Frauenheilkd. 2021 Apr;81(4):469-480. doi: 10.1055/a-1397-7170. Epub 2021 Apr 14.
In recent years, significant progress has been made in new therapeutic approaches to breast cancer, particularly in patients with HER2-positive and HER2-negative/hormone receptor-positive (HR+) breast cancer. In the case of HER2-positive tumours, these approaches have included, in particular, treatment with pertuzumab, T-DM1, neratinib and, soon, also tucatinib and trastuzumab deruxtecan (neither of which has yet been authorised in Europe). In patients with HER2-/HR+ breast cancer, CDK4/6 inhibitors and the PIK3CA inhibitor alpelisib are of particular importance. Further novel therapies, such as Akt kinase inhibitors and oral SERDs (selective estrogen receptor down regulators), are already being investigated in ongoing clinical trials. These therapeutic agents are not only being introduced into curative, (neo-)adjuvant therapeutic settings for HER2-positive tumours; a first favourable study on abemaciclib as an adjuvant therapy has now also been published. In patients with triple-negative breast cancer, after many years of negative study results with the Trop-2 antibody drug conjugate (ADC) sacituzumab govitecan, a randomised study has been published that may represent a significant therapeutic advance. This review describes the latest developments in breast cancer subsequent to the ESMO Congress 2020.
近年来,乳腺癌的新治疗方法取得了显著进展,尤其是在HER2阳性和HER2阴性/激素受体阳性(HR+)乳腺癌患者中。对于HER2阳性肿瘤,这些方法尤其包括使用帕妥珠单抗、曲妥珠单抗-美坦新偶联物、来那替尼治疗,不久之后还将包括图卡替尼和曲妥珠单抗德曲妥珠单抗(两者均尚未在欧洲获得批准)。在HER2阴性/HR+乳腺癌患者中,CDK4/6抑制剂和PIK3CA抑制剂阿培利司尤为重要。其他新型疗法,如Akt激酶抑制剂和口服选择性雌激素受体下调剂(SERD),已在正在进行的临床试验中进行研究。这些治疗药物不仅被引入HER2阳性肿瘤的根治性、(新)辅助治疗方案中;关于阿贝西利作为辅助治疗的首个有利研究现已发表。在三阴性乳腺癌患者中,经过多年使用Trop-2抗体药物偶联物(ADC)戈沙妥珠单抗的阴性研究结果后,一项随机研究已发表,这可能代表了重大的治疗进展。本综述描述了2020年欧洲肿瘤内科学会(ESMO)大会之后乳腺癌的最新进展。