AGO Recommendations for the Diagnosis and Treatment of Patients with Locally Advanced and Metastatic Breast Cancer: Update 2021

Thill, Marc; Friedrich, Michael; Kolberg‐Liedtke, Cornelia; Albert, Ute‐Susann; Banys‐Paluchowski, Maggie; Bauerfeind, Ingo; Blohmer, Jens-Uwe; Budach, Wilfried; Dall, P.; Fallenberg, Eva Maria; Fasching, Peter A.; Fehm, Tanja; Gerber, Bernd; Gluz, Oleg; Harbeck, Nadia; Heil, Jörg; Huober, Jens; Jackisch, Christian; Kreipe, Hans-Heinrich; Krug, David; Kühn, Thorsten; Kümmel, Sherko; Loibl, Sibylle; Lüftner, Diana; Lux, Michael P.; Maass, Nicolaì; Mundhenke, Christoph; Nitz, Ulrike; Park‐Simon, Tjoung‐Won; Reimer, Toralf; Rhiem, Kerstin; Rody, Achim; Schmidt, Marcus; Schneeweiß, Andreas; Schütz, Florian; Sinn, Hans‐Peter; Solbach, Christine; Solomayer, Erich‐Franz; Stickeler, Elmar; Thomssen, Christoph; Untch, Michael; Witzel, Isabell; Wöckel, Achim; Müller, Volkmar; Janni, Wolfgang; Ditsch, Nina

doi:10.1159/000516420

Cited by 21 publications

(17 citation statements)

References 38 publications

(48 reference statements)

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“…There was a larger difference with regard to the median progression-free survival between patients treated with chemotherapy and endocrine therapy in more recent years (32.1 months for endocrine monotherapy versus 5.5 months for chemotherapy) than in the years before the introduction of CDK4/6 inhibitors (11.7 months versus 9.3 months). ▶ Table 2 Cox regression analysis for progression-free and overall survival, showing adjusted hazard ratios 1 ▶ Fig. 2 Frequency of chosen therapies in the full analysis population according to the year of the beginning of therapy (the first CDK4/6 inhibitor was approved in Germany in November 2016.…”

Section: Changes Of Therapeutic Pattern Patient Characteristics and P...mentioning

confidence: 99%

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Implementation of CDK4/6 Inhibitors and its Influence on the Treatment Landscape of Advanced Breast Cancer Patients – Data from the Real-World Registry PRAEGNANT

Engler

Fasching

Lüftner³

et al. 2022

Geburtshilfe Frauenheilkd

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Background Comprehensive data from prospective clinical trials have led to a high level of evidence establishing CDK4/6 inhibitors in combination with endocrine treatment (CDK4/6i + ET) as a standard for the treatment of HER2-negative, hormone receptor-positive (HER2− HR+) breast cancer patients in the first-line advanced therapy setting. Data on patient populations that have been treated in the real-world setting may provide an insight into changes of patient characteristics and prognosis over time. Methods The data were extracted from the prospective real-world registry PRAEGNANT (NCT02338167). Patients had to have HER2− HR+ advanced breast cancer in the first-line metastatic setting. The chosen therapies were described as well as progression-free survival (PFS) and overall survival (OS) in relation to the given therapies and time periods during which they were indicated. Results CDK4/6 inhibitors have been rapidly implemented since their introduction in November 2016. In recent years (2018 – 2022), about 70 – 80% of the patient population have been treated with CDK4/6 inhibitors, while endocrine monotherapy was given to about 10% and chemotherapy to about 15% of all patients. The prognosis was worst in patients treated with chemotherapy. Recently, mainly patients with a good prognosis are being treated with endocrine monotherapy, and patients who are treated with chemotherapy have an unfavorable prognosis. The PFS and OS of patients treated with CDK4/6i + ET have remained similar over time despite changes in patient characteristics. Conclusion A treatment with CDK4/6i + ET has rapidly become the therapy standard for patients in the first-line advanced breast cancer setting. After the implementation of CDK4/6i + ET, endocrine monotherapy is only given to patients with a very favorable prognosis, while chemotherapy is provided to patients with a rather unfavorable prognosis. These changes in patient characteristics did not seem to influence the prognosis of patients treated with CDK4/6i + ET.

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Section: Changes Of Therapeutic Pattern Patient Characteristics and P...mentioning

confidence: 99%

“…1 Hazard ratios were obtained from a multivariable Cox regression model having the predictors shown in the table. Survival analyses were carried out separately for the first three years of the follow-up period and the time afterwards because the proportional hazard assumptions were not fulfilled for the whole follow-up period.…”

mentioning

confidence: 99%

Implementation of CDK4/6 Inhibitors and its Influence on the Treatment Landscape of Advanced Breast Cancer Patients – Data from the Real-World Registry PRAEGNANT

Engler

Fasching

Lüftner³

et al. 2022

Geburtshilfe Frauenheilkd

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“…For patients with HER2-negative HR-positive advanced breast cancer, all endocrine therapy options should first be exhausted 7 . However, real-world data show that even after the introduction of CDK4/6 inhibitors, about 40 – 50% of patients in the second or third line of therapy are still treated with chemotherapy 8 , while about 80% of patients are already treated with a CDK4/6 inhibitor 9 in the first line of therapy.…”

Section: Her2-low – Biomarker or New Subgroupmentioning

confidence: 99%

Update Breast Cancer 2022 Part 4 – Advanced-Stage Breast Cancer

Aktas

Fehm

Welslau

et al. 2022

Geburtshilfe Frauenheilkd

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For the treatment of patients with advanced HER2-negative hormone receptor-positive breast cancer, several substances have been introduced into practice in recent years. In addition, other drugs are under development. A number of studies have been published over the past year which have shown either an advantage for progression-free survival or for overall survival. This review summarizes the latest results, which have been published at current congresses or in specialist journals, and classifies them in the clinical treatment context. In particular, the importance of therapy with CDK4/6 inhibitors – trastuzumab deruxtecan, sacituzumab govitecan and capivasertib – is discussed. For trastuzumab deruxtecan, an overall survival benefit in HER2-negative breast cancer with low HER2 expression (HER2-low expression) was reported in the Destiny-Breast-04 study. Similarly, there was an overall survival benefit in the FAKTION study with capivasertib. The lack of overall survival benefit for palbociclib in the first line of therapy raises the question of clinical classification.

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“…Wichtige Informationsquellen für Monitoring und Behandlung von Nebenwirkungen bei der Therapie mit ICPi sind die umfangreichen Empfehlungen der American Society of Clinical Oncology [ 1 , 21 ] und der European Society of Medical Oncology [ 11 ] sowie die Empfehlungen der AGO [ 24 ]…”

Section: Monitoring Potenzieller Nebenwirkungenunclassified

Nebenwirkungsmanagement immunonkologischer Therapien – was gibt es zu beachten?

Thomssen

2022

Gynäkologe

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Die immunonkologischen Therapieprinzipien haben unterschiedliche Nebenwirkungsspektren. Neben den akuten therapiebedingten unerwünschten Ereignissen („adverse events“, AE), die bisweilen zu Therapieabbrüchen führen, gibt es AE, die mit einer zeitlichen Latenz, auch lange nach Absetzen der Immunonkologika, auftreten können, etwa autoimmune Reaktionen. Ein Monitoring dieser „immune-related adverse events“ (irAE) ist essenziell. Entscheidend ist es, den Schweregrad möglicher AE abzuschätzen und zu graduieren und andererseits Differenzialdiagnosen in Betracht zu ziehen und auszuschließen. Anhand des mittels der Common Terminology Criteria for Adverse Events Skala graduierten Schweregrads von AE erfolgen ggf. klinisch-therapeutische Reaktionen und Konsequenzen.

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AGO Recommendations for the Diagnosis and Treatment of Patients with Locally Advanced and Metastatic Breast Cancer: Update 2021

Cited by 21 publications

References 38 publications

Implementation of CDK4/6 Inhibitors and its Influence on the Treatment Landscape of Advanced Breast Cancer Patients – Data from the Real-World Registry PRAEGNANT

Implementation of CDK4/6 Inhibitors and its Influence on the Treatment Landscape of Advanced Breast Cancer Patients – Data from the Real-World Registry PRAEGNANT

Update Breast Cancer 2022 Part 4 – Advanced-Stage Breast Cancer

Nebenwirkungsmanagement immunonkologischer Therapien – was gibt es zu beachten?

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