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Aktuelle Urol 2015; 46(06): 467-472
DOI: 10.1055/s-0041-106136
Übersichtsarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Die Systemische Behandlung des metastasierten Nierenzellkarzinoms – Zurück in die Zukunft?

Systemic Treatment of Metastatic Renal Cell Cancer – Back to the Future?
P. Ivanyi
1   Klinik für Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover
,
V. Grünwald
1   Klinik für Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover
› Author Affiliations
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Publication History

Publication Date:
10 November 2015 (online)

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Zusammenfassung

Zur systemischen Therapie des metastasierten Nierenzellkarzinoms (mNCC) stehen gegenwärtig eine Vielzahl von Therapeutika zur Verfügung.

Die Zytokintherapie stellte die erste Generation der medikamentösen Tumortherapie des mNCC dar. Erst mit der Entwicklung der zielgerichteten Therapie in der letzten Dekade konnte eine deutliche Verbesserung der Tumortherapie erzielt werden und hat zur Entwicklung der sequenziellen Therapie des mNCC geführt. Aktuell stehen 7 zielgerichtete Medikamente zur Verfügung (Axitinib, Bevacizumab/IFNα, Everolimus, Pazopanib, Sorafenib, Sunitinib und Temsirolimus). Im Zuge der Individualisierung der Therapie stellt die Auswahl des geeigneten Medikamentes die größte Herausforderung für den Behandler dar. Kenntnis der Datenlage, sowie individuelle Faktoren bilden dabei die Grundlage der Medikamentenwahl.

Die Suche nach dem besten Inhibitor oder Kombination hat die letzten Jahre der klinischen Forschung geprägt, ohne dass ein wesentlicher Fortschritt erzielt werden konnte. Stattdessen läutet die aktuelle Entwicklung neuer spezifischer Immuntherapeutika die Entwicklung der nächsten Stufe der Tumortherapie des mNCC ein. Erste Studien werden für dieses Jahr erwartet, weitere Studien zur Optimierung dieser neuen Therapieoption werden folgen.

Abstract

A variety of therapeutic agents are currently available for the systemic treatment of metastatic renal cell carcinoma (mRCC). It was only when targeted treatment was developed in the past decade that a significant improvement was achieved in tumour therapy. This also led to the development of sequential treatment for mRCC.

7 molecular targeted agents are available today (axitinib, bevacizumab/ IFNα, everolimus, pazopanib, sorafenib, sunitinib, and temsirolimus). Due to the individualisation of treatment it remains a challenge to choose the most appropriate drug in a given setting, with the choice being based on the knowledge of the relevant clinical data as well as individual patient parameters.

During the recent past, efforts have been made to test different inhibitors or combinations without a major breakthrough. Instead, the development of novel specific immunotherapeutic approaches now heralds the next level of treatment in mRCC. The first significant trial results will be expected this year, and further trials for optimisation of treatment are warranted.

Schlüsselwörter

Metastasiertes Nierenzellkarzinom - Axitinib - Bevacizumab/IFNα - Everolimus - Pazopanib - Sorafenib - Sunitinib - Temsirolimus

Key words

metastatic renal cell carcinoma - axitinib - bevacizumab/IFNα - everolimus - pazopanib - sorafenib - sunitinib - temsirolimus

Editorial Comment

 

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