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Personalisierte Medizin bei soliden Tumoren

Personalized medicine for solid tumors

Zusammenfassung

Ein personalisierter Therapieansatz wird in der Behandlung solider Tumore seit Entdeckung der Hormonabhängigkeit von Mammakarzinomen verfolgt. Die verbesserten technischen Möglichkeiten, einen Tumor über die Organzugehörigkeit und den histopathologischen Befund hinaus zu charakterisieren, bringen neue Therapiemöglichkeiten hervor. Im Folgenden werden bereits existierende gezielte Therapieansätze und Resistenzmechanismen beschrieben. Neben einer Erläuterung der praktischen Anwendung der neuen Techniken wie Genexpressionsprofile und die Untersuchung von Tumormaterial auf somatische Mutationen in einer Vielzahl von Genen wird auch der neuen Entwicklung einer Therapie auf der Basis von Keimbahnmutationen in den Genen BRCA1 und BRCA2 mit dem PARP-Inhibitor Olaparib Rechnung getragen und ein Ausblick auf zukünftige Entwicklungen wie Liquid Biopsy erbracht.

Abstract

Personalized medicine has been used for the therapy of solid tumors since the detection of the hormonal dependence of breast cancer. Improved techniques to characterize a tumor beyond the organ of primary cancer as well as histopathologic reports enable the implementation of new therapeutic strategies. Below, some of the existing targeted therapies and mechanisms of resistance are described. Besides providing a description of new techniques, such as gene expression analysis, and the analysis of tumor-derived DNA on somatic mutations in many genes, we address the development of a new therapy based on a germline mutation in the genes BRCA1 and BRCA2 with the PARP inhibitor Olaparib, and give an outlook to future developments, such as liquid biopsy.

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Correspondence to Norbert Arnold.

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Interessenkonflikt

K. Kast gibt an, dass sie an einem Advisory Board Meeting von Roche teilnahm. N. Arnold nahm am Regionalen Advisery Board Meeting von AstraZeneca teil.

Alle beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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Kast, K., Arnold, N. Personalisierte Medizin bei soliden Tumoren. medgen 28, 443–451 (2016). https://doi.org/10.1007/s11825-016-0116-0

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Schlüsselwörter

  • Gezielte Therapie
  • Solide Tumore
  • Mutation
  • Antikörper
  • Signalweg

Keywords

  • Targeted therapy
  • Solid tumors
  • Mutation
  • Antibody
  • Signaling cascade