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Warum haben Tyrosinkinaseinhibitoren in der adjuvanten Situation versagt bzw. können Checkpoint-Inhibitoren eher Sinn machen?

Why have tyrosine kinase inhibitors failed in the adjuvant situation and do checkpoint inhibitors make more sense?

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An Erratum to this article was published on 11 March 2020

This article has been updated

Zusammenfassung

Bei einem nicht unbeträchtlichen Rezidivrisiko, insbesondere bei Patienten mit hohem Risikoprofil nach organerhaltender Nierentumoroperation oder Nephrektomie, erscheint eine adjuvante Therapie beim Nierenzellkarzinom sinnvoll. Nach Fehlschlagen von Versuchen mit den älteren Immuntherapeutika oder Vakzinetherapien setzte man Hoffnung in die zielgerichteten VEGF/R-Inhibitoren („vascular endothelial growth factor/receptor“). Aber auch diese brachten bisher enttäuschende Ergebnisse. In diesem Zusammenhang sind die Instrumente zur Patientenauswahl zu diskutieren. Ob bei vergleichbaren Auswahlkriterien aktuell laufende Studien mit Checkpoint-Inhibitoren bessere Ergebnisse zeigen werden, bleibt abzuwarten.

Abstract

In view of a considerable risk of recurrence especially in patients with a high-risk profile after organ-sparing surgery or nephrectomy, adjuvant treatment seems to make sense in renal cell carcinoma. After the failed attempts using older immunotherapeutics or vaccination therapies, new hope was put in the panel of targeted VEGF/R inhibitors. But the results from these studies published so far are also disappointing. In this context the instruments for selecting the best suitable patients for adjuvant trials have to be discussed. It remains to be seen whether using the same selection criteria as in ongoing trials with checkpoint inhibitors will show better results.

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Change history

  • 11 March 2020

    Leider sind im Zuge der Lektoratsbearbeitung in diesem Beitrag zwei Fehler entstanden.

    Bei der im Artikel behandelten Studie handelt es sich um die PROTECT-Studie („Study to Evaluate Pazopanib as an Adjuvant Treatment for Localized Renal Cell Carcinoma (RCC)“).

    Die Legende der Tab. 1 muss zudem …

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Authors and Affiliations

  1. Klinik für Urologie, Kinderurologie und urologische Onkologie, Ev. Kliniken Essen Mitte, Huyssens Stiftung, Henricistr. 92, 45136, Essen, Deutschland

    Susanne Krege

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  1. Susanne Krege
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Correspondence to Susanne Krege.

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S. Krege hat Vortrags- und Beratungshonorare erhalten von den Firmen Bayer, BMS, Esai, Ipsen, MSD, Roche und Takeda.

Für diesen Beitrag wurden von der Autorin keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Krege, S. Warum haben Tyrosinkinaseinhibitoren in der adjuvanten Situation versagt bzw. können Checkpoint-Inhibitoren eher Sinn machen?. Urologe 59, 149–154 (2020). https://doi.org/10.1007/s00120-020-01142-8

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