Der Stellenwert von Aromatasehemmern der dritten Generation in der endokrinen Therapie des Mammakarzinoms - Zeit zum Umdenken?

Zusammenfassung

Endokrine Therapien spielen eine wichtige Rolle in der Behandlung des hormonsensitiven Mammakarzinoms. Dabei rücken die Aromatasehemmer der dritten Generation aufgrund ihrer hohen antitumorösen Potenz und guten Verträglichkeit zunehmend in den Vordergrund. Aufgrund der aktuellen Datenlage stellen Letrozol und Anastrozol nach ihrer Zulassung jetzt reale Alternativen zum bisherigen Standard Tamoxifen in der First-line-Therapie des metastasierten Mammakazinoms dar. Erste Ergebnisse zu den Studien mit Letrozol, Anastrozol und Exemestan in der neoadjuvanten und adjuvanten Situation liegen bereits vor oder werden in Kürze erwartet. In Abhängigkeit von diesen Studien sollte der adjuvante Einsatz der Aromataseinhibitoren bei der postmenopausalen hormonrezeptorpositiven Patientin abschließend definiert werden.

Abstract

Endocrine therapy is a major part of the management of patients with hormone-sensitive breast cancer. The antitumor activity and good tolerability of the third-generation aromatase inhibitors make them an attractive alternative to tamoxifen. Several well conducted randomized trials led to the regulatory approval of letrozole and anastrozole for the first-line treatment of metastatic breast cancer. Multiple ongoing clinical trials are evaluating letrozole, anastrozole and exemestane in the adjuvant and neoadjuvant settings. The results of these trails will determine the role of aromatase inhibitors, alone or sequentially with tamoxifen, in the adjuvant treatment of postmenopausal women with hormone-sensitive breast cancer.

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