Kleinzelliges Lungenkarzinom

Das kleinzellige Lungenkarzinom stellt eine besonders aggressive Tumorentität dar und ist durch schnellen Progress, sehr frühe Metastasierung und eine schlechte Prognose charakterisiert. Nur wenige Patienten werden in einem frühen Erkrankungsstadium diagnostiziert. Die systemische Therapie stellt die entscheidende Therapieform für die Mehrzahl der Patienten dar. Kürzlich konnte das systemische Therapiespektrum durch die Implementierung der Immuntherapie erstmal seit Jahrzehnten erweitert werden.

Kernaussagen

• Das kleinzellige Lungenkarzinom ist durch eine äußerst aggressive Verlaufsform, eine frühe Metastasierung und schlechte Prognose charakterisiert.

• Alle Patienten sollten nach der aktuellen TNM-Stadieneinteilung klassifiziert und im Tumorboard interdisziplinär besprochen werden.

• Bei kurativer Zielsetzung ist die Standardtherapie eine kombinierte Radiochemotherapie, die idealerweise simultan durchgeführt werden sollte.

• Im frühen Tumorstadium (N0, N1) kann eine vollständige Resektion mit adjuvanter Chemotherapie angestrebt werden.

• Die Mehrzahl der Tumoren werden bereits im metastasierten Stadium diagnostiziert, bei denen eine (Kombinations-)Chemotherapie mit palliativer Intention die Standardtherapie darstellt.

• Als neuer Therapiestandard im fortgeschrittenen Stadium gilt die Kombination aus Platin, Etoposid und den Checkpointinhibitoren Atezolizumab oder Durvalumab.

Schlüsselwörter

Lungenkrebs - Bronchialkarzinom - Chemotherapie - Strahlentherapie - Tumorresektion - Checkpointinhibitor

Publication History

Article published online:
13 December 2021

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