Interdisziplinäre Empfehlungen zur Behandlung des metastasierten Nierenzellkarzinoms

Zusammenfassung

Mit der Einführung zielgerichteter Substanzen hat die Therapie des metastasierten Nierenzellkarzinoms einen Paradigmenwechsel erfahren: Der Einsatz von Zytokinen als langjährige Standardtherapie rückte in den Hintergrund, neue Medikamente wie Sunitinib, Sorafenib, Bevacizumab und Temsirolimus haben sich als Behandlungsstandard etabliert. Welche Kriterien beim Einsatz dieser Substanzen zu berücksichtigen sind und welche Fragen auf Basis der aktuellen Studienlage noch unbeantwortet bleiben, war Gegenstand einer Konsensuskonferenz. Das interdisziplinäre Board knüpfte an Therapieempfehlungen aus dem Jahr 2007 an [22]. Das Ergebnis der Diskussion wird hier in Form von Thesen zusammengefasst.

Abstract

With the introduction of targeted therapies, a paradigm shift for the treatment of metastatic renal cell cancer has taken place. New compounds like sunitinib, sorafenib, bevacizumab and temsirolimus have become established as new therapeutic standards. An interdisciplinary consensus conference was held to discuss treatment sequences and open questions. Results from the 2007 conference [22] provided the basis for the 2008 meeting. The results of the 2008 conference are presented as short theses.

Nierenzellkarzinom - Metastasen - medikamentöse Therapie - gezielte Therapie

renal cell cancer - metastases - medical treatment - targeted Therapy

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1 Memorial Sloan-Kettering Cancer Center (MSKCC) Risikofaktoren:
– niedriges Hämoglobin (< Normwert)
– erhöhtes korrigiertes Kalzium (> 10 mg / dl)
– erhöhte Laktatdehydrogenase (> 1,5-facher Normwert)
– schlechter Performance-Status (Karnofsky < 80 %)
– Zeit von der Erstdiagnose bis zur Behandlung < 1 Jahr
MSKCC-Risikogruppen zur Abschätzung des Progressionsrisikos:
– Risikogruppe 1 (niedriges Risiko) = 0 Risikofaktoren
– Risikogruppe 2 (mittleres Risiko) = 1 oder 2 Risikofaktoren
– Risikogruppe 3 (hohes Risiko) = 3–5 Risikofaktoren