Geburtshilfe Und Frauenheilkunde最新文献

{"title":"Hypertensive Disorders in Pregnancy (HDP): Diagnostics and Therapy. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/018, June 2024).","authors":"Ulrich Pecks, Marc Baumann, Julia Binder, Christine Contini, Anne Dathan-Stumpf, Ralf Dechend, Birgit Enna-Kirchmair, Thorsten Fischer, Thierry Girard, Susanne Greve, Tanja Groten, Andreas Hartung, Sven Kehl, Maria Koch, Andrea Köbke, Peter Kranke, Olav Lapaire, Silke Mader, Lars Christian Rump, Alexandra Sperling, Holger Stepan, Sylvia Stracke, Stefan Verlohren, Frauke von Versen-Höynck, Karl Winkler, Michael Zemlin, Dietmar Schlembach","doi":"10.1055/a-2522-2347","DOIUrl":"https://doi.org/10.1055/a-2522-2347","url":null,"abstract":"<p><p><b>Aim</b> This S2k guideline of the German Society of Gynecology and Obstetrics (DGGG) contains consensus-based recommendations for the care and treatment of women with hypertension in pregnancy. It aims to serve as a guide for all professions involved in the care of pregnant women and to improve interprofessional and interdisciplinary cooperation. A new focus was placed on patients' long-term health beyond the postpartum period. <b>Methods</b> The existing S2k guideline was revised and the relevant literature reviewed. Where new questions arose, they were formulated and developed in PICO format. A targeted systematic literature search was carried out using PubMed. Other international guidelines were also consulted. After summarizing and presenting the available data, recommendations and statements were developed, discussed, and agreed on by the guideline group. <b>Recommendations</b> The recommendations cover prediction, prevention, diagnosis, and treatment from the moment hypertensive disease is detected in pregnancy as well as postpartum, in the puerperium, and during breastfeeding. A major change from the previous version of the guideline is the reduction in blood pressure levels that should be achieved during pregnancy. Suggestions are made on how to proceed with regards to the long-term health of mother and child, which the guideline group believes is currently regulated inadequately in the German healthcare system.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 8","pages":"810-850"},"PeriodicalIF":1.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Adjuvant Targeted Treatment of Early Hormone Receptor-positive HER2-negative Breast Cancer: Olaparib, Abemaciclib or Ribociclib - Which One, How and For Whom?","authors":"Stefan Lukac, Kerstin Pfister, Henning Schäffler, Elena Leinert, Angelina Fink, Brigitte Rack, Visnja Fink, Wolfgang Janni, Sabine Heublein","doi":"10.1055/a-2617-2084","DOIUrl":"https://doi.org/10.1055/a-2617-2084","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/a-2562-8469.].</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 6","pages":"e2"},"PeriodicalIF":2.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Certification of a Rural Endometriosis Clinic Leads to Improvement in the Diagnosis and Treatment of Endometriosis - a Retrospective Analysis.","authors":"Cynthia Kohl, Jana Kager, Raul Donutiu, Michael Gerken, Thomas Papathemelis","doi":"10.1055/a-2593-0666","DOIUrl":"10.1055/a-2593-0666","url":null,"abstract":"<p><strong>Introduction: </strong>Endometriosis is a very common benign condition in women. In recent years certification of health care institutions has led to a more standardized care for endometriosis patients, aiming at improving the quality of diagnosis and treatment. The introduction of a common classification system facilitates quantification of disease extent. This study investigated whether certification of a rural endometriosis clinic ameliorated care in endometriosis patients.</p><p><strong>Methods and material: </strong>A single-center retrospective data analysis was performed of all endometriosis patients that underwent surgery at the investigated institution, certified in 2019, for the years 2018-2022.</p><p><strong>Results: </strong>Between 2018 and 2022, a total of 812 surgeries were performed, with certification significantly improving diagnostic and surgical outcomes. Post-certification, there was an increase in ultrasound utilization (47.7% vs. 35.6%, p = 0.007), greater recognition of adenomyosis (65.8% vs. 57.0%, p = 0.035), and higher rates of complete lesion removal (92.5% vs. 87.8%, p = 0.011). Pain outcomes also improved, with more patients achieving pain relief 12 months postoperatively (40.5% vs. 34.5%, p = 0.196 vs. < 0.001). Additionally, certification enhanced follow-up assessments (64.1% vs. 40.7%, p < 0.001) and documentation of rectal lesions in patients with dyschezia (p < 0.001), indicating a positive impact on overall care quality.</p><p><strong>Conclusion: </strong>This study shows that certification significantly improved care for endometriosis patients. Certification enhanced diagnostic precision, increased the use of ultrasound, improved surgical outcomes, and enabled more nuanced application of the #Enzian scoring system. Follow-up assessments became more consistent, reflecting stronger quality control. Despite remaining challenges, certification elevated the clinic's standard of care and emphasized patient-centered management.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 9","pages":"941-950"},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Surgery in Endometrial Cancer: Superior for Low-Risk and Comparable for High-Risk Cases in a 20-Year Cohort Study.","authors":"Valentina Auletta, Maya Ehab Hassan, Angela Kather, Nikolaus Gaßler, Davit Bokhua, Ingo B Runnebaum","doi":"10.1055/a-2589-0498","DOIUrl":"10.1055/a-2589-0498","url":null,"abstract":"<p><strong>Objective: </strong>Minimally invasive surgery (MIS) to treat endometrial cancer offers advantages over laparotomy, although concerns about its oncological safety for high-risk tumors and feasibility in patients with significant comorbidities remain. This study evaluates perioperative and long-term outcomes of MIS versus open surgery in a tertiary referral center cohort, using FIGO 2010 and 2023 classifications.</p><p><strong>Methods: </strong>This is a retrospective analysis of perioperative outcomes, recurrence rates, and survival after endometrial cancer surgery (2000-2021) at an ESGO training center and tertiary referral center in Germany. 760 patients underwent hysterectomy, and adequate data for risk classification (without molecular diagnostics) was available for 330 of them.</p><p><strong>Results: </strong>More than one third of the patients were aged 70 years or older and approximately half of the patients were obese. A high proportion presented with comorbidities such as hypertension or diabetes. MIS demonstrated favorable perioperative results in both low-risk and high-risk patients. Survival analysis showed a superior outcome with MIS for low-risk (5-year RFS rate: 79.8% vs. 59.2%, p = 0.035; OS rate: 83.8% vs. 58.0%, p = 0.010) and FIGO 2023 stage I disease (OS: p = 0.014). The oncological safety of MIS was equivalent to that of open surgery for high-risk tumors (5-year RFS rate: 60.5% vs. 54.3%, p = 0.506; OS rate: 67.5% vs. 58.3%, p = 0.416) and FIGO 2023 stages II (RFS, p = 0.453; OS, p = 0.378) and III (RFS, p = 0.419; OS, p = 0.850).</p><p><strong>Conclusion: </strong>MIS was found to have superior outcomes for low-risk endometrial cancer and a comparable safety for high-risk patients, including those with older age or significant comorbidities. These findings support the use of MIS approaches as viable options across diverse risk groups, in line with FIGO 2023.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 7","pages":"724-735"},"PeriodicalIF":2.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Baseline Characteristics and Therapeutic Management Strategies in Metastatic Cervical Cancer in Germany: A Multicentric Retrospective Longitudinal Observational Study: A Quality Assurance Initiative of the AGO-Study Group and AGO-OK Uterus.","authors":"Dominik Denschlag, Bastian Czogalla, Florian Heitz, Markus Kerkmann, Laura-Christin Fangmann, Philip H Klecker, Frederik A Stuebs, Linn Wölber, Julia Radosa, Pia C Lodde, Stephan Seitz, Christian George, Pawel Mach, Angelina Fink, Davit Bokhua, Nikolaus deGregorio, Björn Lampe, Franziska Hemptenmacher, Verena Friebe, Markus Fleisch, Pauline Wimberger, Anna Jaeger, Andreas Schnelzer, Suzana Mittelstadt, Dominik Ratiu, Michael Eichbaum, Adriana Haus, Matthias Kalder, Beyhan Ataseven, Willibald Schröder, Holger Bronger, Jens Kosse, Uwe Andreas Ulrich, Gabriele Elser, Philipp Harter","doi":"10.1055/a-2520-5736","DOIUrl":"10.1055/a-2520-5736","url":null,"abstract":"<p><strong>Introduction: </strong>Real-world data on treatment patterns and outcomes in recurrent or metastatic cervical cancer (r/mCC) are lacking.</p><p><strong>Methods: </strong>This first national quality assurance initiative was a retrospective analysis of patients with r/mCC diagnosed between 2018 and 2022, who were identified from medical records of 31 gynecologic cancer centers in Germany. Patient demographic and clinical characteristics, treatment patterns, and clinical outcomes were assessed descriptively. Progression-free (PFS) and overall survival (OS) were calculated using Kaplan-Meier analysis.</p><p><strong>Results: </strong>A total of 503 eligible patients (median age 55 years) were analyzed for r/mCC. 276/503 patients (55%) received first-line (1L) chemotherapy (platinum combination: 247/276; 79%) followed by targeted antibody therapy with bevacizumab (177/247; 72%), immunotherapy (19/247; 8%), or both combined (50/247; 20%). 111/503 (22%) received chemotherapy only (platinum combination: 64/111; 58%, platinum mono: 35/111; 31%, or platinum-free: 12/111; 11%), and 110/503 (22%) did not receive any systemic treatment (the remaining 6/503 patients received immunotherapy only). For these subgroups after a median follow-up of 16 months, the PFS was 12 months (95% CI 11-14), 8.8 months (95% CI 7.1-11), and 3 months (95% CI 2.3-4.8), and OS was 25 months (95% CI 21-31), 17 months (95% CI 14-22), and 3.6 months (95% CI 2.8-5.3), respectively. 176/283 (62%) patients who developed progressive disease (PD) were treated with second-line (2L) therapy.</p><p><strong>Conclusion: </strong>Only half of the patients with r/mCC were treated 1L with platinum-combination therapy including antibody therapy according to national guidelines. Moreover, 22% at initial diagnosis and 38% of patients at PD were not treated with systemic therapy at all. This might reflect poor general performance status, patients' preference, and/or lack of effective therapies especially in 2L treatment.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 5","pages":"520-532"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update Breast Cancer 2024 Part 3 - Patients with Advanced Stage Breast Cancer.","authors":"Diana Lüftner, Hans-Christian Kolberg, Andreas D Hartkopf, Tanja N Fehm, Manfred Welslau, Volkmar Müller, Florian Schütz, Peter A Fasching, Christian Jackisch, Frederik Marme, Katharina Keller, Manuel Hörner, Chloë Goossens, Erik Belleville, Michael Untch, Marc Thill, Hans Tesch, Nina Ditsch, Julia C Radosa, Maggie Banys-Paluchowski, Achim Wöckel, Nadia Harbeck, Elmar Stickeler, Rupert Bartsch, Bahriye Aktas, Andreas Schneeweiss, Johannes Ettl, Florin-Andrei Taran, Wolfgang Janni, Rachel Würstlein, Michael P Lux","doi":"10.1055/a-2515-2366","DOIUrl":"10.1055/a-2515-2366","url":null,"abstract":"<p><p>The use of CDK4/6 inhibitors, the new PI3K/AKT-kinase inhibitors, selective estrogen receptor-degraders (SERDs), antibody-drug conjugates, immune therapies and PARP inhibitors in recent years has resulted in a marked change in the therapy landscape for patients with advanced stage breast cancer. CDK4/6 inhibitors, trastuzumab deruxtecan, and sacituzumab govitecan have all been shown to provide significant overall survival benefits compared to conventional chemotherapy. Other substances are also showing promising results and hold out the hope that further analysis of the overall survival benefits will be available in the near future. The speed at which studies are now being carried out has markedly increased, and conferences and specialist journals are now constant sources of new information. This review summarizes the most recent publications and conference presentations on the treatment of patients with advanced stage breast cancer.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 5","pages":"507-519"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Analysis of the Incidence of Serous Tubal Intraepithelial Carcinoma (STIC) in Germany - Evaluation of the Cancer Registry of the Federal State of Rhineland-Palatinate from 2016 to 2023.","authors":"Valerie Catherine Linz, Alina Breuer, Philipp Leppert, Nils Herm-Stapelberg, Katja Schwarzer, Annette Hasenburg","doi":"10.1055/a-2555-4602","DOIUrl":"10.1055/a-2555-4602","url":null,"abstract":"<p><strong>Introduction: </strong>Serous tubal intraepithelial carcinomas (STIC) are classified as precursor lesions of high-grade serous carcinomas (HGSC) in women. STIC are rare and their incidence, prognosis and therapy remain unclear. Since 2021, all cases of isolated STIC in Germany must be reported, which means that all STICs in the German federal state of the Rhineland-Palatine (RLP) are available for evaluation.</p><p><strong>Material and methods: </strong>A systematic search of the pathology reports in the RLP cancer registry was carried out for the period 01/2016-12/2023 using keywords related to STIC, and the results of the search were evaluated.</p><p><strong>Results: </strong>382 pathology reports were identified as relevant and screened. A total of seven patients with isolated STIC were reported to the RLP registry in the years 2020-2022. This corresponds to 0.014% of all reported cases of cancer in women in RLP in this period. Six patients had a diagnosis of isolated STIC, identified during risk-reducing salpingo-oophorectomy (RRSO). The mean patient age at the time of RRSO was 60.29 (± 7.09) years. RRSO was carried out on average 9.38 (± 6.75) years after a primary diagnosis of breast cancer/DCIS in five patients. No HGSC was reported for any of the patients with isolated STIC in the follow-up period until 01/2024. 43 synchronous STICs were reported for the period from 01/2016 to 12/2023.</p><p><strong>Conclusion: </strong>2-3 diagnoses of isolated STIC were recorded annually in RLP in the years 2020-2022. To date, there have been no reports of HGSC in these patients. In the future, the systematic recording of STICs will be expanded to include the cancer registries of other federal states of Germany and it will be possible to obtain valid data on the incidence of STIC in Germany. The collected data will also provide the basic information for a national STIC registry.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 5","pages":"541-547"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor on \"Effects of Systematically Guided vs. Self-Directed Laparoscopic Box Training on Learning Performances\".","authors":"Florian Recker, Ricarda Neubauer","doi":"10.1055/a-2539-5940","DOIUrl":"10.1055/a-2539-5940","url":null,"abstract":"","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 5","pages":"548-550"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update Breast Cancer 2024 Part 2 - Patients with Early Stage Breast Cancer.","authors":"Wolfgang Janni, Hans-Christian Kolberg, Andreas D Hartkopf, Tanja N Fehm, Manfred Welslau, Volkmar Müller, Florian Schütz, Peter A Fasching, Christian Jackisch, Frederik Marme, Manuel Hörner, Katharina Keller, Chloë Goossens, Erik Belleville, Michael Untch, Marc Thill, Hans Tesch, Nina Ditsch, Michael P Lux, Maggie Banys-Paluchowski, Achim Wöckel, Nadia Harbeck, Elmar Stickeler, Rupert Bartsch, Bahriye Aktas, Andreas Schneeweiss, Johannes Ettl, Florin-Andrei Taran, Diana Lüftner, Rachel Würstlein, Julia C Radosa","doi":"10.1055/a-2533-2783","DOIUrl":"10.1055/a-2533-2783","url":null,"abstract":"<p><p>This review summarizes the latest developments for the treatment of patients with early-stage breast cancer. Most of the clinically relevant changes were the result of using immune checkpoint inhibitors to treat patients with triple-negative breast cancer (TNBC) and CDK4/6 inhibitors to treat patients with hormone receptor-positive, HER2-negative (HRpos/HER2neg) tumors and a high risk of recurrence. Recent studies are presenting more and more data with long follow-up times and integrating translational analyses to evaluate new biomarkers such as circulating tumor DNA (ctDNA). This review article summarizes the latest developments published in recent months and puts the findings in context.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 5","pages":"493-506"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjuvant Targeted Treatment of Early Hormone Receptor-positive HER2-negative Breast Cancer: Olaparib, Abemaciclib or Ribociclib - Which One, How and For Whom?","authors":"Stefan Lukac, Kerstin Pfister, Henning Schäffler, Elena Leinert, Angelina Fink, Brigitte Rack, Visnja Fink, Wolfgang Janni, Sabine Heublein","doi":"10.1055/a-2562-8469","DOIUrl":"10.1055/a-2562-8469","url":null,"abstract":"<p><p>With around 70000 new cases every year, breast cancer (BC) continues to be the most prevalent form of cancer. Hormone receptor-positive, HER2-negative (HR+/HER2-) BC is the most common type and accounts for around 70% of cases of early BC (eBC). The development of new drugs in recent years has significantly improved the survival of patients with eBC. Alongside established endocrine therapy (ET) options such as tamoxifen, aromatase inhibitors (AI), and GnRH analogs, additional treatment options such as CDK 4/6 inhibitors (abemaciclib and ribociclib) and the PARP inhibitor (olaparib) are now also available. To facilitate their use in clinical practice, this article provides a summary of the current information on the use of these drugs in clinical practice. Abemaciclib was approved for the adjuvant treatment of HR+/HER2- eBC in cases with positive lymph node involvement in 2022. The MonarchE trial showed that the addition of abemaciclib to ET improved invasive disease-free survival (iDFS) after 5 years by around 7.6% in patients with a high risk of recurrence. Ribociclib, another CDK4/6 inhibitor, was recently approved based on the results of the NATALEE trial. When combined with non-steroidal AIs, ribociclib showed a significant iDFS benefit of 4.9% after 4 years in node-positive and node-negative patients with a high risk of recurrence. The PARP inhibitor olaparib may be used to treat patients with BRCA germline mutation and HR+/HER2- eBC and a high risk of recurrence (CPS-EG score ≥ 3). The OlympiA approval study showed an iDFS benefit of 7.3% after four years and a benefit of 3.4% for overall survival. In summary, targeted therapies are expanding the range of adjuvant treatment options for patients with HR+/HER2- eBC and a higher risk of recurrence. Treating physicians are increasingly facing the challenge of choosing the optimal therapy for their patients. To do so, it is essential to carefully weigh up potential side effects against the expected benefit of treatment on a case-by-case basis.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 6","pages":"590-598"},"PeriodicalIF":2.4,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}