Orale Tumortherapie: Evaluation und Optimierung der Behandlung am Beispiel der endokrin-basierten Therapie bei Patienten/-innen mit HR+/HER2- metastasierten Mammakarzinom

Henze, Franziska (2025): Orale Tumortherapie: Evaluation und Optimierung der Behandlung am Beispiel der endokrin-basierten Therapie bei Patienten/-innen mit HR+/HER2- metastasierten Mammakarzinom. Dissertation, LMU München: Medizinische Fakultät

Abstract

According to guidelines, for the largest group of patients with initial diagnosis of hormone receptor-positive, HER2-negative advanced or metastatic breast cancer, endocrine-based therapy is the standard therapy1. Since the approval of CDK4/6-inhibitors in Europe in 2016, the sequences of treatment and procedures for patients with hormone-receptor positive metastatic breast cancer have changed substantially. In comparison with intra-venous or oral chemotherapy, endocrine-based therapy has different side effects, different diagnostic and therapeutic consequences. The objectives of treatment with these new substances are optimal drug efficacy and treatment duration as well as maintaining max-imum independence, adherence and quality of life for patients while preserving resources for medical staff such as oncologists and nurses. Regarding endocrine-based therapy, there is a new situation with respect to indication, education, side effect management, adherence control and patient support. Some of the substances also show an improvement in disease-free survival in adjuvant treatment of early high-risk breast cancer. Therefore, further targeted oral tumor therapies as well as expansion of the indications for previously established therapies can be expected in the future. This PhD project consists of preparation and planning the implementation of a nurse- con-sultation in oral tumor therapy. For this purpose, therapy preferences of patients and prac-titioners are determined and the care effort for patients with HR+/HER2-advanced breast cancer under oral tumor therapy using the example of CDK4/6-inhibitors is recorded. Ad-ditionally, interdisciplinary structures of the breast center and processes from indication to long-term care are analysed. The obtained results show that the care effort for patients under oral tumor therapy, are highest both before the start of therapy and during the first 3-4 months. After successful treatment of possible side effects, as well as dose reduc-tions and modifications, the care effort for the treatment team decreases substantially and often remains stable over many years. Due to the possibility of delegating certain medical tasks to non-medical team members, nursing staff are increasingly being involved in the context of nurse consultations in oral tumor therapy. In order to meet the increasing demands of high-quality care, future-oriented concepts must be integrated into therapy management. These include regular further training opportunities for nurses or integration of aids, such as e-Health and apps, as well as restructuring of the oncological treatment teams. The findings obtained in the course of this dissertation serve as a foundation for the man-agement of additional oral tumor therapies and the implementation of nursing consulta-tions in oral tumor therapy within oncology therapy units.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Deutsch
• Datum der mündlichen Prüfung: 19. August 2025
• 1. Bericht­erstatter:in: Harbeck, Nadia