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. Vor kurzem wurde das therapeutische Spektrum durch Everolimus und Pazopanib erweitert. Welche Kriterien beim Einsatz dieser Medikamente 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 2010 an [1]. Das Ergebnis der Diskussion wird hier in Form von Thesen zusammengefasst. 

Abstract

With the introduction of targeted drug therapies, a paradigm shift for the treatment of metastatic renal cell carcinoma has taken place. New compounds like sunitinib, sorafenib, bevacizumab and temsirolimus have become established as new therapeutic standards to replace the use of cytokines as standard therapy. Recently, these substances have been complemented by everolimus and pazopanib. An interdisciplinary consensus conference was held to discuss which criteria to consider when using these drugs (treatment sequence) and what questions remain unanswered based on the current study situation (open questions). Results from the 2009 conference provided the basis for the 2010 meeting. The results of the 2010 conference are presented as short theses. 

Nierenzellkarzinom - Metastasen - medikamentöse Therapie

renal cell cancer - metastases - medical treatment

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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
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