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Der Hautarzt

, Volume 57, Issue 9, pp 773–784 | Cite as

Therapie des metastasierten Melanoms

First-, Second- und pathogeneseorientierte Third-line-Therapien
  • K. RassEmail author
  • D. Tadler
  • W. Tilgen
Leitthema

Zusammenfassung

Die Inzidenz des malignen Melanoms weist weltweit eine deutliche Zunahme auf. Entscheidend für eine kurative Therapie ist die Früherkennung des Tumors. Bei Auftreten von Fernmetastasen sind die verfügbaren Therapieoptionen weit überwiegend palliativ. Bei Operabilität und lokalisiertem Befund stellt die Tumorchirurgie das derzeit effektivste Verfahren dar. Bei inoperablen Fernmetastasen gilt Dacarbazin nach wie vor als First-line-Zytostatikum der Wahl mit Ansprechraten von nur 5–20% und ohne Einfluss auf das Gesamtüberleben. Ein großes Spektrum innovativer Therapieansätze wurde in jüngster Zeit aus Erkenntnissen über die Tumorbiologie generiert. Neben der Verbesserung immunologischer Verfahren steht die Targeted-Therapie im Fokus. Mit gezielten antiproliferativen, antiangiogenetischen und proapoptotischen Substanzen sollen pathogenetisch relevante Prozesse in der Tumorzelle blockiert werden. Erste klinische Erfahrungen sind überzeugend, Ergebnisse aus kontrollierten Studien bleiben abzuwarten.

Schlüsselwörter

Malignes Melanom Chemotherapie Tumorchirurgie Vakzinierung Targeted-Therapie 

Therapy of malignant melanoma

First-, second- and pathogenesis-oriented third-line therapies

Abstract

The incidence of malignant melanoma is steadily increasing worldwide. The most crucial requirement to cure the disease is early detection of thin primary tumors. At the stage of distant metastases, the treatment options are predominantly palliative. Resection of localized metastases is currently the most effective approach. Dacarbazine is considered as standard chemotherapy for inoperable metastatic disease showing remission rates of 5–20% without any noteworthy effect on overall survival. Quite recently, a large spectrum of innovative treatment approaches have been developed from an increasing insight into tumor biology. Along with improved vaccination strategies, targeted therapies have attracted the most attention in the treatment of advanced melanoma. Those anti-proliferative, anti-angiogenic and proapoptotic agents are directed against pathogenetically important pathways of the tumor cell. First clinical experiences are encouraging, but results from controlled trials have to be awaited.

Keywords

Malignant melanoma Chemotherapy Tumor surgery Vaccination Targeted therapy 

Notes

Interessenkonflikt

Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

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Copyright information

© Springer Medizin Verlag 2006

Authors and Affiliations

  1. 1.Klinik für Dermatologie, Venerologie und AllergologieUniversitätsklinikum des SaarlandesHomburg

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