Systemische Therapie des nichtkleinzelligen Lungenkarzinoms

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Zusammenfassung

Lungenkrebs ist eine der häufigsten Tumorerkrankungen, wobei das nichtkleinzellige Lungenkarzinom etwa 80% aller bösartigen Lungentumoren ausmacht. Die Therapie orientiert sich an den verschiedenen Stadien; seit dem Jahr 2010 gilt das neue, in siebter Fassung vorliegende Stadiensystem der Union Internationale Contre le Cancer (UICC), das sowohl auf kleinzellige als auch nichtkleinzellige Lungenkarzinome angewendet wird. Die adjuvante Therapie ist Standard in der Therapiestrategie der frühen Stadien nach R0-Resektion. In den letzten Jahren sind erhebliche Fortschritte in der Systemtherapie basierend auf molekularbiologischen Erkenntnissen und den neuen Möglichkeiten einer histologieadaptierten Therapie gemacht worden. Insbesondere die Systemtherapie in der metastasierten Situation orientiert sich differenziert am histologischen Subtyp. Der Lungenkrebs von Patienten, die nie oder zeitlebens nur wenig geraucht haben, ist molekularbiologisch eine andere Erkrankung als die der Raucher, mit einer hohen Rate an EGFR-Mutationen. Erstere haben eine günstigere Prognose und können zielgerichteteren Therapien zugeführt werden. Der vorliegende Beitrag gibt einen Überblick über den derzeitigen Wissenstand. Die aktuellen Empfehlungen zur Erstlinien-, Zweitlinien- und Erhaltungstherapie werden dargestellt.

Schlüsselwörter

Stadiensystem Chemotherapie Monoklonale Antikörper Tyrosinkinasehemmer Erhaltungstherapie 

Systemic therapy of non-small cell lung cancer

Abstract

Lung cancer is one of the most frequent tumors and non-small cell lung cancer makes up about 80% of all malignant lung tumors. Therapy is stratified according to the clinical and pathological stage and since 2010 the new Union for International Cancer Control (UICC) 7 staging system has been implemented for both small cell and non-small cell lung cancer. Adjuvant therapy has become a standard of care in the early stages after R0 resection and in the last few years significant progress has been made in the systemic treatment of lung cancer. Selection of chemotherapeutics is now made according to the histological subtype of lung cancer. Lung cancer of never smokers and of light smokers seems to be a molecularly and prognostically different disease than lung cancer of smokers with a high incidence of epidermal growth factor receptor (EGFR) mutations in never and light smokers. For patients with EGFR mutated lung cancer targeted therapies have been licensed in the European Union.

The article summarizes the current knowledge of treatment for NSCLC and gives recommendations for first line, second line and consolidation therapy strategies.

Keywords

Staging Chemotherapy Monoclonal antibodies Tyrosine kinase inhibitors Consolidation therapy 

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Abteilung für Internistische OnkologiePius-Hospital OldenburgOldenburgDeutschland

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