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Therapie des metastasierten Urothelkarzinoms

Therapy of metastatic urothelial cancer

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best practice onkologie Aims and scope

Zusammenfassung

Der Goldstandard in der Therapie des metastasierten oder inoperablen Urothelkarzinoms ist die Kombinationschemotherapie aus Gemcitabin und Cisplatin in der Erstlinie sowie die Immuntherapie mit den Checkpointinhibitoren Pembrolizumab, Atezolizumab oder Nivolumab in der Zweitlinie. Mit Pembrolizumab und Atezolizumab können nun aber auch Patienten, die aufgrund ihrer Komorbiditäten und/oder Nierenfunktion nicht für eine cisplatinhaltige Chemotherapie in Frage kommen, in der Erstliniensituation behandelt werden. Zukünftig werden zielgerichtete Arzneimittel und Immuntherapeutika, u. a. in der Erhaltungstherapie, die Therapielandschaft des fortgeschrittenen Urothelkarzinoms weiter beeinflussen.

Abstract

The gold standard for the therapy of metastatic or inoperable urothelial cancer is the combination of gemcitabine and cisplatin as first-line treatment and immunotherapy with pembrolizumab, atezolizmab or nivolumab as second-line treatment. For patients who are not eligible for standard cisplatin-containing chemotherapy, pembrolizumab and atezolizumab are first-line treatment options. In the future, targeted therapies and immunotherapeutics, e.g., in maintenance therapy, will influence the therapeutic landscape of advanced urothelial carcinoma.

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Authors and Affiliations

  1. Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    H. E. Fender, M. C. Hupe, M. W. Kramer &  A. S. Merseburger

  2. Institut für Pathologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

    F. F. Dreßler

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  1. H. E. Fender
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  2. F. F. Dreßler
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  3. M. C. Hupe
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  5. A. S. Merseburger
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Correspondence to A. S. Merseburger.

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Interessenkonflikt

F.F. Dreßler gibt Bundesministerium für Bildung und Forschung, Else Kröner-Fresenius-Stiftung, AstraZeneca und Coloplast an. M.W. Kramer gibt Beratertätigkeit für Bristol-Myers Squibb, Janssen, MSD, Merck Serono, Novartis und Roche an, erhält Vortragshonorare von Bristol-Myers Squibb, Eisai, MSD, Merck Serono, Janssen, Roche und Sanofi sowie Reisekostenzuschüsse von Pierre Fabre, Ipsen und Novartis. A.S. Merseburger gibt Beratertätigkeit für AstraZeneca, Astellas, Bristol-Myers Squibb, Ipsen, Janssen, EUSAPharm, MSD, Merck Serono, Novartis, Takeda, Pfizer und Roche an, erhält Honorare von AstraZeneca, Bristol-Myers Squibb, Eisai, Ipsen, MSD, Merck Serono, Janssen, Takeda, Astellas, Novartis, Pfizer und Roche sowie Forschungsförderung von AstraZeneca, Wyeth, Bristol-Myers Squibb, Janssen, Novartis und Pfizer. H.E. Fender und M.C. Hupe geben an, dass kein Interessenkonflikt besteht.

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

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A. Merseburger, Lübeck

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Fender, H.E., Dreßler, F.F., Hupe, M.C. et al. Therapie des metastasierten Urothelkarzinoms. best practice onkologie 15, 368–376 (2020). https://doi.org/10.1007/s11654-020-00243-2

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  • DOI: https://doi.org/10.1007/s11654-020-00243-2

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