Individualisierte Therapie für Patienten mit fortgeschrittenen Lungenkarzinomen

Zusammenfassung

Chirurgische Resektion, Strahlentherapie und Platin-basierte Kombinationschemotherapie sind seit Jahren die etablierten Standbeine der Behandlung von Patienten mit nicht kleinzelligen Lungenkarzinomen (NSCLC). Moderne Operations- und Bestrahlungstechniken, die Einführung der adjuvanten Chemotherapie sowie komplexe, multimodale Therapieprotokolle führten zu verbesserten Behandlungsergebnissen für Patienten mit lokalisierten und lokal fortgeschrittenen NSCLC. Hingegen war für die große Gruppe der Patienten mit inoperablen oder metastasierten Tumoren lange Zeit kein Therapiefortschritt zu erreichen. Durch eine differenzierte Betrachtung der inhomogenen Gruppe der NSCLC sowie insbesondere durch die Anwendung molekularpathologischer Analysen konnte diese Stagnation in den letzten Jahren überwunden und die Entwicklung in Richtung einer Therapieindividualisierung angestoßen werden. Der vorliegende Artikel bietet eine Übersicht des aktuellen Standes der klinischen Anwendung dieser Forschungsergebnisse und gibt einen Ausblick auf künftige therapeutische Strategien, die neben Histologie und Tumorstadium durch die biologischen Eigenschaften der individuellen Tumorerkrankung bestimmt sein werden.

Abstract

Surgical resection, radiotherapy and platinum-based combination chemotherapy are the mainstay for the treatment of patients with advanced non-small cell lung cancer (NSCLC). Modern surgical and radiation techniques as well as complex multimodal therapy protocols were able to improve treatment results for patients with localized or locally advanced NSCLC. However, until recently no progress has been made for the large group of patients suffering from irresectable or metastasized tumors. A distinct histopathological view of the inhomogenous group of NSCLC as well as the application of molecular diagnostics were able to initiate the development of concepts for individualized therapies in order to overcome this stagnation. The present review focuses on the status quo of the clinical relevance of these recent developments and provides an outlook on upcoming therapeutic strategies, which will be influenced not only by histology and tumour stage but also by the biological properties of the individual cancer.

Schlüsselwörter

nicht kleinzelliges Bronchialkarzinom - NSCLC - prädiktiv - individualisierte Therapie - EGFR - TKI

Key words

non-small cell lung cancer - NSCLC - predictive - individualized therapy - EGFR - TKI

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