Prävention, Diagnostik, Therapie und Nachsorge des Lungenkarzinoms

Zusammenfassung

Die aktuelle Fassung der Leitlinie Lungenkarzinom trägt der Dynamik der Informationen in diesem Fachbereich Rechnung. Insbesondere gelten folgenden Empfehlungen:

Die Vorstellung aller neu diagnostizierten Patienten im interdisziplinären pneumoonkologischen Tumorboard ist verpflichtend, das CT-Screening für asymptomatische Risikopersonen (nach Zulassung durch die Behörden), Vorgehen beim inzidentellen Lungenrundherd (außerhalb von Screeningprogrammen), molekulare Testung aller NSCLC unabhängig vom Subtyp, in frühen Stadien auf EGFR-Mutationen und in der Rezidivsituation, adjuvante TKI-Therapie bei Vorliegen einer EGFR-Mutation, adjuvante Konsolidierung mit Checkpointinhibitor bei PD-L1 ≥ 50%, Erhebung des PD-L1-Status, nach Radiochemotherapie bei PD-L1-pos. Tumoren Konsolidierung mit Checkpointinhibitor, adjuvante Konsolidierung mit Checkpointinhibitor bei PD-L1 ≥ 50% im Stadium IIIA, Erweiterung des therapeutischen Spektrums bei PD-L1 ≥ 50%, unabhängig von PD-L1Status, neue zielgerichtete Therapieoptionen sowie die Einführung der Immunchemotherapie in der SCLC Erstlinie.

Um eine zeitnahe Umsetzung künftiger Neuerungen zu gewährleisten, wurde die Umstellung auf eine „living guideline“ für das Lungenkarzinom befürwortet.

Abstract

The current S3 Lung Cancer Guidelines are edited with fundamental changes to the previous edition based on the dynamic influx of information to this field:

The recommendations include de novo a mandatory case presentation for all patients with lung cancer in a multidisciplinary tumor board before initiation of treatment, furthermore CT-Screening for asymptomatic patients at risk (after federal approval), recommendations for incidental lung nodule management , molecular testing of all NSCLC independent of subtypes, EGFR-mutations in resectable early stage lung cancer in relapsed or recurrent disease, adjuvant TKI-therapy in the presence of common EGFR-mutations, adjuvant consolidation treatment with checkpoint inhibitors in resected lung cancer with PD-L1 ≥ 50%, obligatory evaluation of PD-L1-status, consolidation treatment with checkpoint inhibition after radiochemotherapy in patients with PD-L1-pos. tumor, adjuvant consolidation treatment with checkpoint inhibition in patients withPD-L1 ≥ 50% stage IIIA and treatment options in PD-L1 ≥ 50% tumors independent of PD-L1status and targeted therapy and treatment option immune chemotherapy in first line SCLC patients.

Based on the current dynamic status of information in this field and the turnaround time required to implement new options, a transformation to a „living guideline“ was proposed.

Publication History

Article published online:
26 October 2023

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