Der Gastroenterologe

, Volume 5, Issue 1, pp 57–71

Aktuelle Therapie des Kolonkarzinoms

CME Weiterbildung · Zertifizierte Fortbildung

Zusammenfassung

Das kolorektale Karzinom zählt zu den häufigsten Malignomen weltweit. Allein in Deutschland werden nach den Daten des Robert-Koch-Instituts etwa 63.000 Neuerkrankungen pro Jahr diagnostiziert. Die Sterblichkeit liegt hier bei etwa 30.000 Patienten pro Jahr. Bei bis zu 20% der Patienten finden sich bei der Erstdiagnose eines Kolonkarzinoms bereits Fernmetastasen. Allerdings zeigen neue Daten, dass das Vorhandensein von Metastasen eines Kolonkarzinoms per se noch keine palliative Situation bedingt und Patienten bei einer vollständigen Resektion von isolierten Leber- oder Lungenmetastasen eine Chance auf Heilung ihrer Tumorerkrankung haben. Die Auswahl der medikamentösen Therapie des Kolonkarzinoms richtet sich heutzutage nach dem Stadium der Erkrankung, aber auch nach der individuellen Situation des Patienten. Die Einführung zielgerichteter Substanzen („targeted therapies“) hat zu einer Erweiterung der Therapieoptionen geführt. Mit diesen neuen Therapeutika werden in der palliativen Situation mediane Überlebenszeiten bis über 30 Monate erzielt. Durch die Vielzahl an weiteren Therapieoptionen aus dem Bereich der zielgerichteten Substanzen, die in Kürze zur Verfügung stehen werden, wird in Verbindung mit prädiktiven Biomarkern eine personalisierte Therapie des Kolonkarzinoms vorstellbar.

Schlüsselwörter

Kolorektales Karzinom Zielgerichtete Therapie Palliative Behandlung Sequenzielle Therapie Individualisierte Therapie 

Current treatment of colon cancer

Abstract

Colorectal cancer is one of the most common cancers worldwide, with 63,000 new cases diagnosed each year in Germany alone. About 30,000 of these patients die of colorectal cancer every year. In up to 20% of cases, distant metastases are already present at diagnosis. However, new data demonstrate that the presence of metastases per se does not constitute a palliative setting in colorectal cancer. In the case of complete resection of isolated liver or lung metastases, cure is possible for these patients. The choice of systemic treatment increasingly depends not only on the stage of the disease but also on the individual patient situation. The introduction of tumor-specific targeted therapies has considerably increased the therapeutic options. With the use of all available agents, a median overall survival of more than 30 months is achievable in the palliative setting. The multitude of targeted therapies that will be available for treating colorectal cancer in due course opens the door for personalized treatment of colorectal cancer, given that predictive biomarkers also exist to help guide the treatment.

Keywords

Colorectal cancer Targeted therapies Palliative treatment Sequential therapy Personalized treatment 

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Copyright information

© Springer Medizin Verlag 2010

Authors and Affiliations

  1. 1.Klinik für Innere Medizin I, Universitätsklinikum HalleMartin-Luther-Universität Halle-WittenbergHalle (Saale)Deutschland

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