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Aktuelle Therapieansätze beim malignen Melanom mit leptomeningealer Metastasierung

Current therapeutic approaches in malignant melanoma patients with leptomeningeal disease

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best practice onkologie Aims and scope

Zusammenfassung

Trotz fundamentaler Fortschritte im Bereich der Dermatoonkologie bleibt die Prognose einer leptomeningealen Metastasierung (LMM) mit einer durchschnittlichen Überlebenszeit von Wochen bis wenigen Monaten infaust. Das maligne Melanom (MM) zählt zu den soliden Tumoren mit der höchsten Metastasierungstendenz in diesen Raum: Bis zu 10–15 % der Patienten mit fortgeschrittenem MM entwickeln eine leptomeningeale Tumoraussaat. Neben einer initial oftmals schwierigen Diagnosestellung, erweisen sich bis dato durchgeführte Therapiemodalitäten oftmals als unzureichend und wirkungslos; zudem lässt sich ein Anstieg der Inzidenz feststellen. Diese Übersichtsarbeit bietet einen kurzen Überblick über Epidemiologie, Diagnostik sowie aktuelle Therapieansätze eines MM mit LMM. Ein weiterer Fokus richtet sich auf aktuell laufende klinische Studien, bei welchen bereits vielversprechende und zukunftsweisende Ergebnisse vorgestellt wurden.

Abstract

Despite fundamental advances in the field of oncology, the prognosis of leptomeningeal metastasis (LMD) remains poor, with the average overall survival typically measured in weeks to a few months. Malignant melanoma (MM) is one of the solid malignancies with the highest tendency to metastasize to this space: approximately 10–15% of patients with advanced MM develop LMD. In addition to diagnostic challenges, the incidence of LMD appears to be rising; currently available treatment options appear to have very little impact on survival. This review provides a short overview of the epidemiology, diagnosis, and current treatment approaches for MM patients with LMD. Finally, currently ongoing clinical trials are briefly reviewed, for which promising and trendsetting results have already been presented.

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Authors and Affiliations

  1. Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, Dresden, Deutschland

    Julian Steininger

  2. Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Isabella C. Glitza Oliva

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  1. Julian Steininger
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Correspondence to Julian Steininger.

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Interessenkonflikt

I.C. Glitza Oliva gibt folgenden Interessenkonflikt an: research support bei BMS, MERCK und Pfizer. J. Steininger gibt 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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Gabriele Schackert, Dresden

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Steininger, J., Glitza Oliva, I.C. Aktuelle Therapieansätze beim malignen Melanom mit leptomeningealer Metastasierung. best practice onkologie 17, 96–102 (2022). https://doi.org/10.1007/s11654-022-00365-9

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  • DOI: https://doi.org/10.1007/s11654-022-00365-9

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