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Endokrine antihormonelle Therapie in der Prämenopause

Zeitschrift:: Journal für Gynäkologische Endokrinologie/Schweiz > Ausgabe 4/2017

Autor:: Univ.-Ass.-Prof. Dr. Leo Auerbach

Wichtige Hinweise

Dieser Beitrag wird auch im Journal für Gynäkologische Endokrinologie/Österreich 2017, https://doi.org/10.1007/s41974-017-0022-8 veröffentlicht.

Zusammenfassung

Aktuelle Studien haben die Möglichkeiten der Therapie eines prämenopausalen Mammakarzinoms verändert und die Therapieleitlinien der internationalen und nationalen senologischen Gesellschaften ergänzt. Bei prämenopausalen Patientinnen mit niedrigem Rezidivrisiko ohne Chemotherapie bleibt Tamoxifen erste Wahl, wobei bei guter Verträglichkeit nach 5 Jahren die Verlängerung der Therapie mit Tamoxifen auf weitere 5 Jahre erwogen werden kann (individuelle, risikoadaptierte Entscheidung). Sollte die Patientin nach der TAM-Therapie in der Postmenopause sein, wäre eine Therapie mit Aromatasehemmer (AI) für weitere 5 Jahre empfehlenswert. Bei prämenopausalen Patientinnen mit hohem Rezidivrisiko, die eine Chemotherapie benötigen und nach der Chemotherapie noch prämenopausal sind, ist die Therapie mit Exemestan + Ovarian Function Suppression (OFS) (GnRH-Analoga) für 5 Jahre vorteilhaft (auch für Patientinnen mit einer Kontraindikation gegen Tamoxifen (TAM) [z. B. Thrombosen] optional). Bei Unverträglichkeit oder intolerablen Nebenwirkungen stellt die Kombination TAM + OFS eine Alternative dar. Für Patientinnen mit niedrigem Risiko und Kinderwunsch kann auch eine zeitreduzierte Therapieoption mit TAM + GnRH-Analogon Goserelin ± Zoledronsäure für 3 Jahre besprochen werden (ABCSG 12).

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Pan H, Gray RG, Davies C, Peto R, Bergh JCS, Pritchard KI, Dowsett M, Hayes DF, Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2016) Predictors of recurrence during years 5–14 in 46,138 women with ER+ breast cancer allocated 5 years only of endocrine therapy (ET). J Clin Oncol 34(suppl):abstr 505

Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), Davies C, Godwin J, Gray R et al (2011) Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet 378:771–784 CrossRef

Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365:1687–1717 CrossRef

Early Breast Cancer Trialists’ Collaborative Group (1996) Ovarian ablation in early breast cancer: overview of the randomised trials. Lancet 348:1189–1196 CrossRef

Jin H, Tu D, Zhao N, Shepherd LE, Goss PE (2012) Longer-term outcomes of letrozole versus placebo after 5 years of tamoxifen in the NCIC CTG MA.17 trial: analyses adjusting for treatment crossover. J Clin Oncol 30(7):71 CrossRef

Higgins MJ, Liedke PE, Goss PE (2013) Extended adjuvant endocrine therapy in hormone dependent breast cancer: the paradigm of the NCIC-CTG MA.17/BIG 1–97 trial. Crit Rev Oncol Hematol 86:23–32 CrossRefPubMed

Goss PE, Ingle JN, Pritchard KI et al (2016) Extending aromatase-inhibitor adjuvant therapy to 10 years. N Engl J Med 375:209–219 CrossRefPubMedPubMedCentral

ASCO (2016) ASCO educational book

Baum M, Hackshaw A, Houghton J, Rutqvist, Fornander T, Nordenskjold B, Nicolucci A, Sainsbury R, ZIPP International Collaborators Group (2006) Adjuvant goserelin in pre-menopausal patients with early breast cancer: results from the ZIPP study. Eur J Cancer 42(7):895–904 (May) CrossRefPubMed

10.

Cuzick J, Ambroisine L, Davidson N et al (2007) Use of luteinising-hormone-releasing hormone agonists as adjuvant treatment in premenopausal patients with hormone-receptor-positive breast cancer: a meta-analysis of individual patient data from randomised adjuvant trials. Lancet 369:1711–1723 CrossRefPubMed

11.

Hackshaw A, Baum M, Fornander T, Nordenskjold B, Nicolucci A, Monson K, Forsyth S, Reczko K, Johansson U, Fohlin H, Valentini M, Sainsbury R (2009) Long-term effectiveness of adjuvant goserelin in premenopausal women with early breast cancer. J Natl Cancer Inst 101(5):341–349 CrossRefPubMedPubMedCentral

12.

Tevaarwerk AJ, Wang M, Zhao F et al (2014) Phase III comparison of tamoxifen versus tamoxifen plus ovarian function suppression in premenopausal women with node-negative, hormone receptor-positive breast cancer (E-3193, INT-0142): A trial of the Eastern Cooperative Oncology Group. J Clin Oncol 32:3948–3958 CrossRefPubMedPubMedCentral

13.

Gnant M, Mlineritsch B, Schippinger W, Luschin-Ebengreuth G, Pöstlberger S, Menzel C, Jakesz R, Seifert M, Hubalek M, Bjelic-Radisic V, Samonigg H, Tausch C, Eidtmann H, Steger G, Kwasny W, Dubsky P, Fridrik M, Fitzal F, Stierer M, Rücklinger E, Greil R, Marth C, ABCSG-12 Trial Investigators (2009) Endocrine therapy plus zoledronic acid in premenopausal breast cancer. N Engl J Med 360(7):679–691. https://doi.org/10.1056/NEJMoa0806285 CrossRefPubMed

14.

Gnant M, Mlineritsch B, Stoeger H et al (2015) Zoledronic acid combined with adjuvant endocrine therapy of tamoxifen versus anastrozol plus ovarian function suppression in premenopausal early breast cancer: final analysis of the Austrian Breast and Colorectal Cancer Study Group Trial 12. Ann Oncol 26:313–320 CrossRefPubMed

15.

TEXT and SOFT Investigators, International Breast Cancer Study Group, Pagani O, Regan MM, Walley BA et al (2014) Adjuvant exemestane with ovarian suppression in premenopausal breast cancer. N Engl J Med 371:107–118 CrossRef

16.

Kadakia KC, Henry NL (2015) Adjuvant endocrine therapy in premenopausal women with breast cancer. Clin Adv Hematol Oncol 13(10):663–672 PubMedPubMedCentral

17.

Tevaarwerk AJ, Wisinski KB, O’Regan RM (2016) Endocrine therapy in premenopausal hormone receptor-positive breast cancer. J Oncol Pract 12(11):1148–1156 CrossRefPubMed

18.

Cardoso F, Costa A, Senkus E, Aapro M, André F, Barrios CH, Bergh J, Bhattacharyya G, Biganzoli L, Cardoso MJ, Carey L, Corneliussen-James D, Curigliano G, Dieras V, El Saghir N, Eniu A, Fallowfield L, Fenech D, Francis P, Gelmon K, Gennari A, Harbeck N, Hudis C, Kaufman B, Krop I, Mayer M, Meijer H, Mertz S, Ohno S, Pagani O, Papadopoulos E, Peccatori F, Pernault-Llorca F, Piccart MJ, Pierga JY, Rugo H, Shockney L, Sledge G, Swain S, Thomssen C, Tutt A, Vorobiof D, Xu B, Norton L, Winer E (2017) 3rd ESO-ESMO international consensus guidelines for Advanced Breast Cancer (ABC 3). Breast 31:244–259 CrossRefPubMed

19.

Regan MM, Francis PA, Pagani O, Fleming GF, Walley BA, Viale G, Colleoni M, Láng I, Gómez HL, Tondini C, Pinotti G, Price KN, Coates AS, Goldhirsch A, Gelber RD (2016) Absolute benefit of adjuvant endocrine therapies for premenopausal women with hormone receptor-positive, human epidermal growth factor receptor 2‑negative early breast cancer: TEXT and SOFT trials. J Clin Oncol 34(19):2221–2231 CrossRefPubMedPubMedCentral

20.

PALOMA-2, Finn RS, Martin M, Rugo HS et al (2016) Primary results from a phase III trial of palbociclib (P) with letrozole (L) compared with letrozole alone in post-menopausal women with ER+/HER2−advanced breast cancer (ABC). J Clin Oncol 34(suppl):abstr 507

21.

Cristofanilli M, Turner NC, Bondarenko I et al (2016) Fulvestrant plus palbociclib versus fulvestrant plus placebo for treatment of hormone-receptor-positive, HER2-negative metastatic breast cancer that progressed on previous endocrine therapy (PALOMA-3): final analysis of the multicentre, double-blind, phase 3 randomised controlled trial. Lancet Oncol 17:425–439 CrossRefPubMed

22.

Bachelot T, Bourgier C, Cropet C et al (2012) Randomized phase II trial of everolimus in combination with tamoxifen in patients with hormone receptor-positive, human epidermal growth factor receptor 2‑negative metastatic breast cancer with prior exposure to aromatase inhibitors: a GINECO study. J Clin Oncol 30:2718–2724 CrossRefPubMed

23.

Klijn JG, Blamey RW, Boccardo F et al (2001) Combined tamoxifen and luteinizing hormone-releasing hormone (LHRH) agonist versus LHRH agonist alone in pre-menopausal advanced breast cancer: a meta-analysis of four randomized trials. J Clin Oncol 19:343–353 CrossRefPubMed

24.

De Bree E, Makrigiannakis A, Askoxylakis J (2010) Pregnancy after breast cancer. A comprehensive review. J Surg Oncol 101:534–542 CrossRefPubMed

25.

Pagani O, Partridge A, Korde L et al (2011) Pregnancy after breast cancer: if you wish, ma’am. Breast Cancer Res Treat 129:309–317 CrossRefPubMed

26.

Azim HA Jr, Kroman N, Paesmans N et al (2013) Prognostic impact of pregnancy after breast cancer according to estrogen receptor status: a multicenter retrospective study. J Clin Oncol 31:73–79 CrossRefPubMed

27.

Adjuvant Breast Cancer Trials Collaborative Group. (2007) Ovarian ablation or suppression in premenopausal early breast cancer: results from the international adjuvant breast cancer ovarian ablation or suppression randomized trial. J Natl Cancer Inst 99:516–525 CrossRef

28.

Anders CK, Hsu DS, Broadwater G et al (2008) Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. J Clin Oncol 26:3324–3330 CrossRefPubMed

29.

Baselga J, Campone M, Piccart M et al (2012) Everolimus in postmenopausal hormone-receptor-positive advanced breast cancer. N Engl J Med 366:520–529 CrossRefPubMed

30.

Bernhard J, Luo W, Ribi K et al (2015) Patient-reported outcomes with adjuvant exemestane versus tamoxifen in premenopausal women with early breast cancer undergoing ovarian suppression (TEXT and SOFT): A combined analysis of two phase 3 randomised trials. Lancet Oncol 16:848–858 CrossRefPubMedPubMedCentral

31.

Burstein HJ, Lacchetti C, Anderson H et al (2016) Adjuvant endocrine therapy for women with hormone receptor-positive breast cancer: American Society of Clinical Oncology Clinical Practice guideline update on ovarian suppression. J Clin Oncol 34:1689–1701 CrossRefPubMed

32.

Cardoso F, Costa A, Norton L et al (2014) ESO-ESMO 2nd international consensus guidelines for advanced breast cancer (ABC2). Breast 23:489–502 CrossRefPubMed

33.

Coates AS, Winer EP, Goldhirsch A et al (2015) Tailoring therapies – improving the management of early breast cancer: St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015. Ann Oncol 26:1533–1546 CrossRefPubMedPubMedCentral

34.

International Breast Cancer Study Group, Colleoni M, Gelber S, Goldhirsch A et al (2006) Tamoxifen after adjuvant chemotherapy for premenopausal women with lymph node-positive breast cancer: International Breast Cancer Study Group Trial 13–93. J Clin Oncol 24:1332–1341 CrossRef

35.

Cuzick J, Sestak I, Baum M et al (2010) Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 10-year analysis of the ATAC trial. Lancet Oncol 11:1135–1141 CrossRefPubMed

36.

Davies C, Pan H, Godwin J et al (2013) Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet 381:805 CrossRefPubMedPubMedCentral

37.

Dowsett M, Cuzick J, Ingle J et al (2010) Meta-analysis of breast cancer outcomes in adjuvant trials of aromatase inhibitors versus tamoxifen. J Clin Oncol 28:509–518 CrossRefPubMed

38.

Breast Cancer Disease Site Group, Eisen A, Messersmith H, Franek J, et al (2010) Adjuvant ovarian ablation in the treatment of premenopausal women with early stage invasive breast cancer: guideline recommendations

39.

Austrian Breast and Colorectal Cancer Study Group, Gnant M et al (2015) Zoledronic acid combined with adjuvant endocrine therapy of tamoxifen versus anastrozol plus ovarian function suppression in premenopausal early breast cancer: final analysis of the Austrian Breast and Colorectal Cancer Study Group Trial 12. Ann Oncol 26:313–320 CrossRef

40.

Finn RS, Crown JP, Lang I et al (2015) The cyclin-dependent kinase 4/6 inhibitor palbociclib in combination with letrozole versus letrozole alone as first-line treatment of oestrogen receptor-positive, HER2-negative, advanced breast cancer (PALOMA-1/TRIO-18): a randomised phase 2 study. Lancet Oncol 16:25–35 CrossRefPubMed

41.

Fisher B, Dignam J, Bryant J et al (2001) Five versus more than five years of tamoxifen for lymph node-negative breast cancer: updated findings from the National Sur-gical Adjuvant Breast and Bowel Project B‑14 randomized trial. J Natl Cancer Inst 93:684–690 CrossRefPubMed

42.

SOFT Investigators, International Breast Cancer Study Group, Francis PA, Regan MM, Fleming GF, International Breast Cancer Study Group (2015) Adjuvant ovarian suppression in premenopausal breast cancer. N Engl J Med 372:436–446 CrossRef

43.

Goel S Sr, Sharma R, Hamilton A et al (2009) LHRH agonists for adjuvant therapy of early breast cancer in premenopausal women. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD004562.pub3 PubMed

44.

Gray RG, Rea D, Handley K et al (2013) aTTom: Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years in 6,953 women with early breast cancer. J Clin Oncol 31(suppl):abstr 5 CrossRef

45.

Griggs JJ, Somerfield MR, Anderson H et al (2011) American Society of Clinical Oncology endorsement of the Cancer Care Ontario practice guideline on adjuvant ovarian ablation in the treatment of premenopausal women with early-stage invasive breast cancer. J Clin Oncol 29:3939–3942 CrossRefPubMed

46.

Mamounas EP, Jeong JH, Wickerham DL et al (2008) Benefit from exemestane as extended adjuvant therapy after 5 years of adjuvant tamoxifen: Intention-to-treat analysis of the National Surgical Adjuvant Breast and Bowel Project B‑33 trial. J Clin Oncol 26:1965–1971 CrossRefPubMed

47.

Nielsen TO, Jensen M‑B, Gao D et al (2015) High risk premenopausal luminal A breast cancer patients derive no benefit from adjuvant chemotherapy: results from the DBCG77B randomized trial. San Antonio Breast Cancer Symposium, S 1–8 (Abstract)

48.

Partridge AH, Pagani O, Abulkhair O, Aebi S, Amant F, Azim HA Jr, Costa A, Delaloge S, Freilich G, Gentilini OD, Harbeck N, Kelly CM, Loibl S, Meirow D, Peccatori F, Kaufmann B, Cardoso F (2014) First international consensus guidelines for breast cancer in young women (BCY1). Breast 23:209–220 CrossRefPubMed

49.

Ribi K, Luo W, Bernhard J et al (2016) Adjuvant tamoxifen plus ovarian function suppression versus tamoxifen alone in premenopausal women with early breast cancer: patient-reported outcomes in the suppression of ovarian function trial. J Clin Oncol 34:1601–1610 CrossRefPubMedPubMedCentral

50.

Sestak I, Dowsett M, Zabaglo L et al (2013) Factors predicting late recurrence for estrogen receptor-positive breast cancer. J Natl Cancer Inst 105:1504–1511 CrossRefPubMedPubMedCentral

51.

Turner NC, Ro J, André F et al (2015) Palbociclib in hormone-receptor-positive advanced breast cancer. N Engl J Med 373:209–219 CrossRefPubMed

Titel: Endokrine antihormonelle Therapie in der Prämenopause
Autor:: Univ.-Ass.-Prof. Dr. Leo Auerbach
Publikationsdatum: 01.12.2017
DOI: https://doi.org/10.1007/s41975-017-0023-z
Verlag: Springer Vienna
Zeitschrift: Journal für Gynäkologische Endokrinologie/Schweiz Revue de Endocrinologie Gynécologique
Ausgabe 4/2017
Print ISSN: 1995-6924
Elektronische ISSN: 2520-8500

Springer Medizin Österreich

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