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01.02.2010 | Schwerpunkt

Molekulardiagnostik des Lungenkarzinoms zur Therapiestratifizierung

verfasst von: Dr. L.C. Heukamp, R. Büttner

Erschienen in: Die Pathologie | Ausgabe 1/2010

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Zusammenfassung

Das Lungenkarzinom ist die häufigste tumorbedingte Todesursache in den westlichen Industrienationen trotz kontinuierlicher Verbesserung der diagnostischen und therapeutischen Ansätze. Da der epidermale Wachstumsfaktorrezeptor (EGFR) in mehr als 80% nichtkleinzelliger Lungenkarzinome überexprimiert wird und wichtige karzinogene Eigenschaften wie Zellzyklusprogression, Apoptose, Angiogenese und Metastasierung vermittelt, gilt er als relevantes Ziel neuer spezifischer Therapien. Dies hat zur Entwicklung der niedermolekularen EGFR-Tyrosinkinaseinhibitoren (EGFR-TKI) Gefitinib und Erlotinib geführt. Die Prädiktion, welche Patienten auf eine EGFR-gerichtete Therapie ansprechen, ist von bedeutendem klinischem Interesse. Neuere Studien zeigen ein signifikant besseres Ansprechverhalten und verlängertes progressionsfreies Überleben bei Patienten mit EGFR-mutierten Tumoren, auch schon in der „First-line-Therapie“. Darüber hinaus sind inzwischen genetische Veränderungen aufgeklärt worden, die mit primärer EGFR-TKI-Resistenz korrelieren (z. B. KRAS) oder eine sekundäre Resistenz gegen die bekannten TKI bewirken (z. B. EGFR-Mutation T790 M oder MET-Amplifikation). Die prädiktive Diagnostik dieser Veränderungen an histologischem Material gewinnt zunehmend eine Bedeutung bei der Patientenstratifizierung und wird bald nicht nur für das Lugenkarzinom unumgänglich sein.

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Titel: Molekulardiagnostik des Lungenkarzinoms zur Therapiestratifizierung
verfasst von: Dr. L.C. Heukamp
R. Büttner
Publikationsdatum: 01.02.2010
Verlag: Springer-Verlag
Erschienen in: Die Pathologie / Ausgabe 1/2010
Print ISSN: 2731-7188
Elektronische ISSN: 2731-7196
DOI: https://doi.org/10.1007/s00292-009-1241-1

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