Metastasiertes kolorektales Karzinom - Stand derzeitiger Therapieoptionen

Zusammenfassung

Kolorektale Karzinome tragen erheblich zur Mortalität unter den Krebserkrankungen bei. Auch heutzutage ist die Behandlung bei Patienten mit Fernmetastasen größtenteils palliativ. Ein kleiner Teil der Patienten mit isolierten Leber- oder Lungenmetastasen kann durch chirurgische Resektionen geheilt werden. Im Verlauf der letzten 15 Jahre hat sich die systemische Therapie von einem Status ungeprüften Wertes zu einem international akzeptierten, valide geprüften Therapieverfahren mit Lebenszeitverlängerung entwickelt. Andererseits haben zunehmende Erkenntnisse in der molekularen Pathogenese von Malignomen zur Entwicklung neuer selektiver Medikamente geführt, die zu einer zielgerichteten Behandlung durch Blockierung von kritischen intrazellulären Regulationsabläufen der Tumorentwicklung und Progression eingesetzt werden können.

Abstract

Colorectal carcinoma is a major cause of death from cancer. Patients with metastatic disease are considered incurable except for a small subgroup with isolated surgically complete removable lesions in the lungs and the liver. Chemotherapy has evolved from a treatment of unproven value to a well-documented survival prolonging treatment in the last twenty years due to the introduction of new drugs such as the topoisomerase inhibitor irinotecan and the third generation platin compound oxaliplatin. Some patients with isolated liver or lung metastases can now be cured if combination chemotherapy is combined with aggressive hepatic and thoracic surgery. Recently available information about molecular abnormalities in cancer cells which drive its malignant properties such as proliferation, together with advances in biotechnology have prompted in the development of novel therapeutic tools to treat patients with malignant tumors. Therapeutic agents targeting EGFR or VEGF do have a favourable toxicity profile when administrated with currently used 5-fluorouracil based chemotherapy.

Schlüsselwörter

Kolon-Rektum-Karzinom - Fernmetastasen - Chemotherapie - biologische Therapie

Key words

Colorectal carcinoma - distant metastases - chemotherapy - targeted therapy

Literatur

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