|
Abstract
Adjuvant chemotherapy and antibody therapy
in breast cancer If the indication for an adjuvant chemotherapy is given
after a risk/benefit evaluation, anthracycline-based combination
chemotherapy is regarded as standard treatment.
As shown in a metaanalysis, these regimen induce an
additional benefit with a reduction of the relapse rate and
mortality compared with adjuvant CMF-therapy. In the
treatment of nodal-positive disease, taxane-containing
regimen improve relapse-free survival as well as overall
survival compared to taxane-free options. For nodal-negative patients, the situation is not completely clear. In the sequence
AC followed by a taxane, both taxanes are equally
effective;however, the weekly administration of paclitaxel
offers a better DFS (disease free survival) and OS (overall
survival) compared to the three-weekly regime.The sequence
of anthracyclines and docetaxel is equally effective
as the combination.
If under the consideration of the risks (cardiac toxicity,
secondary leukaemia) the potential additional benefit of
an anthracycline-based combination therapy is regarded
as too low, an anthracycline-free combination of docetaxel
and cyclophosphamide can be chosen. Current study
designs will evaluate the role of this non-anthracycline
regimens.
All studies demonstrating a benefit for adjuvant trastzumab
therapy including node-negative and node-positive
patients and subgroup analysis showed a benefit for both
groups of patients.Therefore, trastuzumab-containing
regimens should be also applied in node-negative patients
with risk factors.
CME Prakt Fortbild Gynakol Geburtsmed Gynakol
Endokrinol 2010; 6(1):68-79
Keywords
Breast Cancer,adjuvant chemotherapy,AGO guidelines,
Trastuzumab Volkmar Müller1, Elmar Stickeler2
1 Klinik und Poliklinik für Gynäkologie, Universitätsklinikum
Hamburg-Eppendorf,Hamburg
2Universitäts-Frauenklinik Freiburg, Freiburg
Für die Kommission Mammakarzinom der AGO
Reviewer: Christoph Thomssen, Halle
und Nadia Harbeck,Köln
Müller V. Adjuvante ... Gynakol Geburtsmed Gynakol Endokrinol 2010;6(1):68-79 publiziert 31.03.10 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2010 ISSN 1614-8533
| 
