Zusammenfassung
Beim metastasierten Nierenzellkarzinom ist nach Ausschöpfung aller operativen Maßnahmen die systemische Therapie indiziert, die bis vor kurzem unter wenig befriedigenden Ergebnissen v. a. mit immuntherapeutischen Konzepten erfolgte. Da ein Großteil aller klarzelligen Nierenzellkarzinome gut vaskularisiert ist, bot sich die Angiogenesehemmung als alternative Therapiemaßnahme an. Inzwischen sind 4 Substanzen zur Angiogenesekontrolle in der Nierenzellkarzinombehandlung zugelassen: Sunitinib, Sorafenib, Temsirolimus sowie die Kombination von Bevacizumab und Interferon α. Weitere Substanzen, wie Everolimus, Pazopanib und Axitinib, befinden sich in der klinischen Prüfung. Erste Daten zur Verträglichkeit und Wirksamkeit wurden 2008 auf der Jahrestagung der American Society of Clinical Oncoloy (ASCO) vorgestellt. Im vorliegenden Beitrag werden die Therapieoptionen und ASCO-Daten beleuchtet und zukünftige Trends diskutiert.
Abstract
Once surgical options have been exhausted, systemic therapy is indicated for metastasizing renal cell carcinoma. Until recently this was carried out using mainly immunotherapeutic concepts with unsatisfactory results. Since the majority of clear cell renal cell carcinomas are well vascularised, angiogenetic inhibition offered an alternative therapy goal. To date, four substances have been approved to control angiogenesis in the therapy of renal cell carcinoma: sunitinib, sorafenib, temsirolimus, as well as a combination of bevacizumab and interferon alpha. Other substances, such as everolimus, pazopanib and axitinib, are currently the subject of clinical trials. Initial data on tolerance and efficacy was presented at this years annual conference of the American Society of Clinical Oncology (ASCO). This article examines current therapy options and ASCO data and discusses future trends.
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Der korrespondierende Autor weist auf folgende Beziehung/en hin: Honorare von Bayer, Pfizer, Novartis, Roche, Wyeth
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Staehler, M., Haseke, N., Zilinberg, K. et al. Systemische Therapie des metastasierten Nierenzellkarzinoms. Urologe 47, 1357–1367 (2008). https://doi.org/10.1007/s00120-008-1874-3
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DOI: https://doi.org/10.1007/s00120-008-1874-3