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01.12.2010 | Leitthema

Systemische Therapie des metastasierten Melanoms

verfasst von: Dr. T.K. Eigentler, F. Meier, U. Keilholz, A. Hauschild, C. Garbe

Erschienen in: Die Onkologie | Ausgabe 12/2010

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Zusammenfassung

Erstmalig seit 3 Jahrzenten stehen neue Medikamente für das metastasierte Melanom vor der baldigen Zulassung, und die Behandlung wird sich durch Early-Access-Programme bereits ab 2011 deutlich ändern. Die Therapie des malignen Melanoms im Stadium der Fernmetastasierung bleibt für die Mehrzahl der Patienten dennoch palliativ. Möglichst lang andauernde Remissionen mit Verlängerung der Überlebenszeit werden angestrebt, wobei bei einem kleineren Teil der Patienten auch Heilungen mit den neuen Medikamenten möglich erscheinen. Soweit die Metastasierung ein Organsystem nicht überschreitet und eine operative Entfernung des Tumors möglich ist, ist die operative Metastasenresektion die Therapie der Wahl. Bei ausgedehnter Metastasierung ist eine Systemtherapie indiziert. Neue Therapiestrategien wie die Blockade von „cytotoxic T lymphocyte-associated antigen 4“ (CTLA-4) durch Antikörper induzierten bei einigen Patienten teils lang anhaltende Tumorremissionen und führten zu einer statistisch evidenten Verlängerung des Gesamtüberlebens. Der therapeutische Einsatz von hoch selektiven Tyrosinkinaseinhibitoren zeigte in ersten Phase-II-Studien objektive Ansprechraten von ca. 80% bei vorigem Nachweis der BRAF-V600E-Mutation (bei 40–50% der Melanompatienten vorhanden) und verdeutlicht überzeugend die Notwendigkeit einer individualisierten Tumortherapie in der Zukunft.
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Metadaten
Titel
Systemische Therapie des metastasierten Melanoms
verfasst von
Dr. T.K. Eigentler
F. Meier
U. Keilholz
A. Hauschild
C. Garbe
Publikationsdatum
01.12.2010
Verlag
Springer-Verlag
Erschienen in
Die Onkologie / Ausgabe 12/2010
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-010-1926-3

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