Update Breast Cancer 2020 Part 5 - Moving Therapies From Advanced to Early Breast Cancer Patients.

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.

Informations de copyright

The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).

Déclaration de conflit d'intérêts

Conflict of Interest/Interessenkonflikt M. P. L. has participated on advisory boards for AstraZeneca, Lilly, MSD, Novartis, Pfizer, Eisai, Exact Sciences and Roche and has received honoraria for lectures from MSD, Lilly, Roche, Novartis, Pfizer, Exact Sciences, AstraZeneca, medac and Eisai. A. S. received honoraria from Roche, Celgene, AstraZeneca, Novartis, Pfizer, Zuckschwerdt Verlag GmbH, Georg Thieme Verlag, Aurikamed GmbH, MCI Deutschland GmbH, bsh medical communications GmbH and promedicis GmbH. A. D. H. received speaker and consultancy honoraria from AstraZeneca, Genomic Health, Roche, Novartis, Celgene, Lilly, MSD, Eisai, Teva, Tesaro, Daiichi Sankyo, Hexal and Pfizer. V. M. received speaker honoraria from Amgen, AstraZeneca, Celgene, Daiichi Sankyo, Eisai, Pfizer, Novartis, Roche, Teva, Janssen-Cilag and consultancy honoraria from Genomic Health, Hexal, Roche, Pierre Fabre, Amgen, Novartis, MSD, Daiichi Sankyo and Eisai, Lilly, Tesaro and Nektar. W. J. received honoraria and research grants from Novartis, Roche, Pfizer, Lilly, AstraZeneca, Chugai, Sanofi, Daichi, Tesaro. E. B. received honoraria from Novartis, Hexal and onkowissen.de for consulting, clinical research management or medical education activities. E. S. received honoraria from Roche, Celgene, AstraZeneca, Novartis, Pfizer, Tesaro, Aurikamed GmbH, MCI Deutschland GmbH, bsh medical communications GmbH, Onkowissen TV. M. T. has participated on advisory boards for AstraZeneca, Clovis, Eisai, GSK, Lilly, MSD, Novartis, Pfizer, Exact Sciences, Pierre-Fabre and Roche and has received honoraria for lectures from Clovis, Daiichi Sankyo, GSK, Lilly, MSD, Roche, Novartis, Pfizer, Exact Sciences, and AstraZeneca and has received trial funding by Exact Science. P. A. F. received honoraria from Novartis, Pfizer, Roche, Amgen, Celgene, Daiichi Sankyo, AstraZeneca, Merck-Sharp & Dohme, Eisai, Puma and Teva. His institution conducts research with funding from Novartis and Biontech. H.-C. K. has received honoraria from Carl Zeiss meditec, Teva, Theraclion, Novartis, Amgen, AstraZeneca, Pfizer, Janssen-Cilag, GSK, LIV Pharma, Roche, MSD, SurgVision, Onkowissen and Genomic Health. M. U. received honoraria from AbbVie, Amgen, Astra Zeneca, Celgene, Daichi Sankyo, Eisai, Lilly, MSD Merck, Mundipharma, Myriad Genetics, Pfizer, PUMA Biotechnology, Roche Sanofi Aventis, Novartis, Pierre Fabre – all honoraria to the institution/employer. N. H. reports receipt of honoraria or consultation fees from Amgen, AstraZeneca, Celgene, Daiichi Sankyo, Lilly, MSD, Novartis, Odonate, Pfizer, Roche, Sandoz/Hexal and Seattle Genetics. N. D. has received honoraria from MSD, Roche, AstraZeneca, Teva, Mentor, and MCI Healthcare. C. T. has participated on advisory boards, lectures for Amgen, AstraZeneca, Celgene, Daiichi Sankyo, Eisai, Lilly, MSD, Mundipharma, Medapharm, Novartis, Pfizer, Pierre-Fabre, Roche, Tesaro, and Vifor. M. W. has participated on advisory boards for AstraZeneca, Lilly, MSD, Novartis, Pfizer and Roche. F. S. participated on advisory boards for Novartis, Lilly, Amgen and Roche and received honoraria for lectures from Roche, AstraZeneca, MSD, Novartis and Pfizer. D. L. received honoraria from Amgen, AstraZeneca, Celgene, Lilly, Loreal, MSD, Novartis, Pfizer, Tesaro, Teva. A. W. participated on advisory boards for Novartis, Lilly, Amgen, Pfizer, Roche, Tesaro, Eisai and received honoraria for lectures from Novartis, Pfizer, Aurikamed, Roche, Celgene. The remaining authors have no conflict of interest to declare for this specific article./ M. P. L. hat in Beiräten für AstraZeneca, Lilly, MSD, Novartis, Pfizer, Eisai, Exact Sciences und Roche mitgewirkt und erhielt Vortragshonorare von MSD, Lilly, Roche, Novartis, Pfizer, Exact Sciences, AstraZeneca, medac und Eisai. A. S. erhielt Honorare von Roche, Celgene, AstraZeneca, Novartis, Pfizer, Zuckschwerdt Verlag GmbH, Georg Thieme Verlag, Aurikamed GmbH, MCI Deutschland GmbH, bsh medical communications GmbH und promedicis GmbH. A. D. H. erhielt Vortrags- und Beratungshonorare von AstraZeneca, Genomic Health, Roche, Novartis, Celgene, Lilly, MSD, Eisai, Teva, Tesaro, Daiichi Sankyo, Hexal und Pfizer. V. M. erhielt Vortragshonorare von Amgen, AstraZeneca, Celgene, Daiichi Sankyo, Eisai, Pfizer, Novartis, Roche, Teva, Janssen-Cilag und Honorare für Beratungen von Genomic Health, Hexal, Roche, Pierre Fabre, Amgen, Novartis, MSD, Daiichi Sankyo und Eisai, Lilly, Tesaro und Nektar. W. J. erhielt Honorare und Forschungsförderung von Novartis, Roche, Pfizer, Lilly, AstraZeneca, Chugai, Sanofi, Daiichi Sankyo und Tesaro. E. B. erhielt Honorare für Aktivitäten in den Bereichen Beratung, klinisches Forschungsmanagement oder medizinische Ausbildung von Novartis, Hexal und onkowissen.de. E. S. erhielt Honorare von Roche, Celgene, AstraZeneca, Novartis, Pfizer, Tesaro, Aurikamed GmbH, MCI Deutschland GmbH, bsh medical communications GmbH und Onkowissen TV. M. T. hat in Beiräten für AstraZeneca, Clovis, Eisai, GSK, Lilly, MSD, Novartis, Pfizer, Exact Sciences, Pierre-Fabre und Roche mitgewirkt, Vortragshonorare von Clovis, Daiichi Sankyo, GSK, Lilly, MSD, Roche, Novartis, Pfizer, Exact Sciences und AstraZeneca sowie finanzielle Unterstützung für klinische Studien von Exact Science erhalten. P. A. F. erhielt Honorare von Novartis, Pfizer, Roche, Amgen, Celgene, Daiichi Sankyo, AstraZeneca, Merck-Sharp & Dohme, Eisai, Puma und Teva. Die Forschungsaktivitäten seiner Institution werden von Novartis und Biontech finanziell unterstützt. H.-C. K. hat Honorare von Carl Zeiss meditec, Teva, Theraclion, Novartis, Amgen, AstraZeneca, Pfizer, Janssen-Cilag, GSK, LIV Pharma, Roche, MSD, SurgVision, Onkowissen und Genomic Health erhalten. M. U. erhielt Honorare von AbbVie, Amgen, AstraZeneca, Celgene, Daiichi Sankyo, Eisai, Lilly, MSD Merck, Mundipharma, Myriad Genetics, Pfizer, PUMA Biotechnology, Roche, Sanofi-Aventis, Novartis und Pierre Fabre – alle Honorare an die Institution/Arbeitgeber. N. H. erhielt Honorare oder Beratungsvergütungen von Amgen, AstraZeneca, Celgene, Daiichi Sankyo, Lilly, MSD, Novartis, Odonate, Pfizer, Roche, Sandoz/Hexal und Seattle Genetics. N. D. hat Honorare von MSD, Roche, AstraZeneca, TEVA, Mentor und MCI Healthcare erhalten. C. T. hat für Amgen, AstraZeneca, Celgene, Daiichi Sankyo, Eisai, Lilly, MSD, Mundipharma, Medapharm, Novartis, Pfizer, Pierre-Fabre, Roche, Tesaro und Vifor in Beiräten mitgewirkt und Vorträge gehalten. M. W. hat in Beiräten für AstraZeneca, Lilly, MSD, Novartis, Pfizer und Roche mitgewirkt. F. S. hat in Beiräten für Novartis, Lilly, Amgen und Roche mitgewirkt und erhielt Vortragshonorare von Roche, AstraZeneca, MSD, Novartis und Pfizer. D. L. erhielt Honorare von Amgen, AstraZeneca, Celgene, Lilly, Loreal, MSD, Novartis, Pfizer, Tesaro und Teva. A. W. wirkte in Beiräten für Novartis, Lilly, Amgen, Pfizer, Roche, Tesaro und Eisai mit und erhielt Vortragshonorare von Novartis, Pfizer, Aurikamed, Roche und Celgene. Alle anderen Autoren haben im Hinblick auf diese spezifische Arbeit keinen bestehenden Interessenkonflikt zu erklären.