Die Rolle von Biomarkern in Diagnose, Prognose und Therapie von Patienten unter immunonkologischer Therapie mit urologischen Malignomen

Zusammenfassung

In den letzten Jahren haben Fortschritte in der Grundlagenforschung neue Einsichten in die Tumorbiologie gestattet, dadurch konnten neue Therapien entwickelt werden. Diese Übersichtsarbeit beleuchtet die Rolle des Pathologen und wie er anhand von Gewebemarkern helfen kann, eine Therapieentscheidung zu treffen. Wir erklären die Problematik der molekularen Blasentumoruntergruppen, die Rolle der neoadjuvanten Chemotherapie und die der Immune Checkpoint Inhibitoren, des Weiteren gehen wir auf das Nierenkarzinom und dessen Therapiemöglichkeiten ein, mit besonderem Augenmerk auf das klarzellige Nierenkarzinom als häufigsten Nierenkarzinomtyp. Wir streifen kurz das Prostatakarzinom, das als hormonabhängiger Tumor wahrscheinlich einen anderen Therapieansatz braucht. Wir versuchen, die Machbarkeit und Grenzen vom pathologischen Standpunkt her zu beleuchten.

Abstract

In recent years, fundamental research has yielded new insights into tumour biology, and new treatments have been developed. This review highlights the role of the pathologist and how he can support clinicians to find the right treatment for each patient. We explain the problems of the molecular subgroups of bladder cancer, the role of neo-adjuvant chemotherapy in the context of these findings, and show the important role of checkpoint inhibitors. Furthermore we focus on kidney cancer, with the clear cell carcinoma as the most frequent tumour type. We briefly consider prostate cancer, which as a hormone-dependent tumour probably requires different therapies. We also try to show the feasibility and the limits of pathology with the emerging tumour markers.

Schlüsselwörter

Blasenkarzinom - Nierenkarzinom - Prostatakarzinom - Immune Checkpoint Inhibitoren

Keywords

bladder cancer - kidney cancer - prostate cancer - immune checkpoint inhibitor

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