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Der Stellenwert der Tageted-Therapie beim Peniskarzinom

Value of targeted therapy for penile cancer

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Zusammenfassung

Das Peniskarzinom ist in Westeuropa mit einer Inzidenz von 0,1–0,9/100.000 Männer/Jahr ein seltener maligner Tumor des Urogenitaltrakts. Zum Zeitpunkt der Erstdiagnose weisen bis zu 45% der Patienten Lymphknoten- und/oder systemische Metastasen auf, die einer weitergehenden systemischen Therapie bedürfen. Die Behandlungsergebnisse der Systemtherapie des metastasierten Peniskarzinoms sind bei einer Remissionsrate von ca. 30% und einer 3-Jahres-Überlebensrate von <10% deprimierend gering. Die Identifikation geeigneter „Targets“ zur Etablierung molekular getriggerter Therapieansätze könnte dazu beitragen, die ungünstige Prognose der Patienten zu verbessern.

Zielsetzung der vorliegenden Arbeit ist es, mögliche molekulare „Targets“ zu identifizieren und Therapieansätze aufzuzeigen. Basierend auf den molekularen Grundlagen der Metastasierung erscheinen beim Peniskarzinom die Addition von Bevacizumab oder COX-2-Inhibitoren zur Standardtherapie Erfolg versprechend. Aktuelle klinische Studien zur Targeted-Therapie sind nicht existent, sollten in Form überregionaler Netzwerkstrukturen realisiert werden.

Abstract

With an incidence of 0.1–0.9/100,000 men/year, penile cancer is a rare cancer of the urogenital tract in Western Europe. At the time of initial diagnosis up to 45% of the patients already demonstrate metastatic disease and need some type of systemic treatment. Objective remission rates and 3-year survival rates of 30 and < 10%, respectively, are depressingly low. Identification of molecular targets for the introduction of molecular triggered therapies such as monoclonal antibodies and tyrosine kinase inhibitors might improve the poor prognosis and could replace non-targeted systemic chemotherapies with a less toxic targeted therapy.

However, a MEDLINE search does not identify any current clinical trial with regard to targeted therapeutic approaches in penile cancer. Based on a systematic review of the molecular events involved in the metastatic process of penile cancer, therapeutic approaches with bevacizumab or COX-2 inhibitors appear to have the greatest potential to improve the prognosis. In order to perform a prospective clinical phase 2/3 trial in such a low frequency cancer, international cooperative structures have to be established.

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  1. Klinik und Poliklinik für Urologie, Bereich Urologische Onkologie, Uniklinik, Kerpener Straße 62, 50937, Köln, Deutschland

    A. Heidenreich, D. Thüer & D. Pfister

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  1. A. Heidenreich
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  2. D. Thüer
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Heidenreich, A., Thüer, D. & Pfister, D. Der Stellenwert der Tageted-Therapie beim Peniskarzinom. Urologe 47, 1320–1327 (2008). https://doi.org/10.1007/s00120-008-1749-7

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