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Medikamentöse Therapie des metastasierten Aderhautmelanoms

Drug therapy for metastasizing uveal melanoma

  • Leitthema
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Zusammenfassung

Das Aderhautmelanom unterscheidet sich in der Tumorbiologie und im Metastasierungsverhalten vom kutanen malignen Melanom. Das metastasierte Aderhautmelanom ist eine seltene Erkrankung mit schlechter Prognose. Zu den therapeutischen Möglichkeiten zählen operative Verfahren, die nur für sehr wenige Patienten sinnvoll sind, die systemische Chemotherapie und lokale Behandlungsverfahren wie die Chemoembolisation und die lokoregionäre Chemotherapie über die A. hepatica. Die wenigen vorliegenden klinischen Studien haben nur eine geringe Zahl von Patienten eingeschlossen. Sie belegen eine Wirksamkeit der Chemoembolisation und der lokoregionären Chemotherapie bei Patienten mit alleiniger Metastasierung in die Leber. Bei Patienten mit Metastasierung in mehrere Organe werden zurzeit Zytostatikakombinationen aus Gemcitabin und Treosulfan in klinischen Studien untersucht. Fortemustin, eine moderne Nitroseharnstoffverbindung, stellt ebenfalls eine therapeutische Option dar.

Abstract

Uveal melanoma differs in its tumor biology and metastatic behavior from malignant cutaneous melanoma. Metastasized uveal melanoma has a poor prognosis but is rare. Therapeutic possibilities include surgery, which is only valuable for very few patients, systemic chemotherapy and local treatment possibilities such as chemoembolization and local chemotherapy via the hepatic artery. Only a small number of patients have been included in the few clinical studies available. These show that chemoembolization and local chemotherapy are effective when only liver metastases are present. For patients with metastases in several organs, cytostatic combinations with gemcitabine and treosulfan are currently investigated in clinical studies. Fortemustine, a modern nitrosourea derivative, is also a therapeutic option.

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Authors and Affiliations

  1. Medizinische Klinik III (Hämatologie, Onkologie, Transfusionsmedizin), Charité, Campus Benjamin Franklin

    A. Schmittel, E. Thiel & U. Keilholz

  2. Augenklinik, Charité, Campus Benjamin Franklin

    N. E. Bechrakis & M. H. Foerster

  3. Medizinische Klinik III (Hämatologie, Onkologie, Transfusionsmedizin), Charité, Campus Benjamin Franklin, Hindenburgdamm 30, 12 200 , Berlin

    A. Schmittel

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  1. A. Schmittel
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  2. N. E. Bechrakis
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  3. M. H. Foerster
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  4. E. Thiel
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  5. U. Keilholz
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Correspondence to A. Schmittel.

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Schmittel, A., Bechrakis, N.E., Foerster, M.H. et al. Medikamentöse Therapie des metastasierten Aderhautmelanoms. Onkologe 12, 222–229 (2006). https://doi.org/10.1007/s00761-006-1031-9

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  • DOI: https://doi.org/10.1007/s00761-006-1031-9

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