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Personalisierte Krebsmedizin

Biomarker zur molekularen Therapiestratifizierung im Pankreaskarzinom

Personalized cancer medicine

Biomarkers for molecular therapy stratification in pancreatic carcinoma

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Zusammenfassung

Das duktale Adenokarzinom des Pankreas (PDAC) ist bei steigender Inzidenz mit einer sehr schlechten Prognose assoziiert. Eine Minderheit der Patienten kommt für eine Resektion in Betracht; die Mehrheit ist inoperabel oder zeigt Metastasen bei Erstdiagnose. Da nahezu alle Patienten rezidivieren, steht die palliative Situation klinisch im Vordergrund, in der hauptsächlich konventionelle systemische Chemotherapien eingesetzt werden. Spezifische, durch Biomarker charakterisierbare Tumoreigenschaften können hierbei Aufschluss über mögliche zielgerichtete Therapien im Sinne einer personalisierten Krebsmedizin geben. Auch wenn diese Alterationen mit sehr niedriger Frequenz auftreten, können sie für die Prognose des einzelnen Patienten sehr bedeutsame Auswirkungen haben. Dieser Übersichtsartikel fasst wesentliche Beiträge zu diesen Themen zusammen und gibt einen Ausblick auf ihre klinische Bedeutung.

Abstract

Ductal adenocarcinoma of the pancreas has a very poor prognosis and a rising incidence. Even after curative intent resection, which is possible in a minority of patients, most patients relapse, whereas the majority is diagnosed with inoperable or metastatic disease. That’s why palliative systemic chemotherapy is the current therapeutic mainstay. Biomarker-based tumor characterization could identify potential therapy targets and enable a personalized cancer medicine. Although potentially targetable alterations occur at very low frequencies, the possible impact on patient outcome can be significant. This article summarizes some of the contributions to these aspects and gives an outlook on their clinical meaning.

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Danksagung

Mein besonderer Dank gilt meinen klinischen Kooperationspartnern aus der AG Onkologie der Medizinischen Klinik III/Comprehensive Cancer Center am Klinikum der Universität München. Darüber hinaus möchte ich mich bei Herrn Prof. Dr. Thomas Kirchner für die Unterstützung meiner Forschungstätigkeit neben meiner Ausbildung zum Facharzt für Pathologie bedanken.

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Authors and Affiliations

  1. Pathologisches Institut, Medizinische Fakultät, Ludwig-Maximilians-Universität München, Thalkirchner Straße 36, 80337, München, Deutschland

    S. Ormanns

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S. Ormanns gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Ormanns, S. Personalisierte Krebsmedizin. Pathologe 39 (Suppl 2), 221–224 (2018). https://doi.org/10.1007/s00292-018-0539-2

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