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Metastasiertes Nierenzellkarzinom

Erstlinien- und Sequenztherapie

Metastatic renal cell carcinoma

Primary and follow-up treatment

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Zusammenfassung

Die Einführung neuer medikamentöser Strategien hat die Therapie des metastasierten Nierenzellkarzinoms (NZK) in den vergangenen Jahren grundlegend verändert. Die sog. Target-Therapie bietet heute Patienten mit inkurablem NZK die Chance einer Überlebenszeitverlängerung bei akzeptablem Nebenwirkungsprofil. Verschiedene Tyrosinkinase- und mTOR-Inhibitoren wurden in unterschiedlichen Therapielinien prospektiv randomisiert geprüft, sodass in aktuellen Leitlinien einzelne Substanzen in definierten klinischen Szenarien empfohlen werden. Die optimale therapeutische Sequenz ist noch nicht definiert. Aktuelle Daten sprechen jedoch für den Einsatz eines Tyrosinkinaseinhibitors in der Erstlinienbehandlung. Neue therapeutische Ansatzpunkte werden derzeit in Studien evaluiert.

Abstract

Systemic treatment of metastatic renal cell carcinoma has changed fundamentally in recent years. So-called targeted therapy gives patients with incurable renal cell cancer the chance of prolonged survival with acceptable quality of life and manageable side effects. Several tyrosine kinase inhibitors and mTOR inhibitors have been evaluated in various clinical settings within prospective trials. Therefore, recent medical guidelines are able to give recommendations for the management of advanced renal cell carcinoma in daily practice. The optimal therapeutic sequence of the available substances has not been defined until now; however recent data recommend the use of a tyrosine kinase inhibitor as the first line treatment. Besides standard treatment, new approaches are currently being evaluated in clinical trials.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Steiner erklärt, beratend für die Firmen Pfizer und Novartis tätig gewesen zu sein. G.H. Mickisch erklärt, beratend für die Firmen Astellas/Avio, Bayer, GSK, Novartis, Pfizer und Roche tätig gewesen zu sein. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Klinik für Urologie, Helios Klinikum Erfurt GmbH, Nordhäuser Straße 74, 99089, Erfurt, Deutschland

    T. Steiner & G.H. Mickisch

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  1. T. Steiner
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  2. G.H. Mickisch
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Correspondence to T. Steiner.

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Steiner, T., Mickisch, G. Metastasiertes Nierenzellkarzinom. Urologe 52, 1529–1533 (2013). https://doi.org/10.1007/s00120-013-3248-8

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  • DOI: https://doi.org/10.1007/s00120-013-3248-8

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