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Erschienen in: Die Onkologie 2/2022

02.12.2021 | Nierenkarzinom | CME

Risikostratifizierung und Therapiealgorithmus des metastasierten Nierenzellkarzinoms

verfasst von: Susan Foller, Katharina Leucht, Prof. Dr. med. Marc-Oliver Grimm

Erschienen in: Die Onkologie | Ausgabe 2/2022

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Zusammenfassung

Die systemische Therapie des metastasierten Nierenzellkarzinoms hat sich in den letzten beiden Jahrzehnten kontinuierlich weiterentwickelt. Dabei wurden signifikante Verbesserungen bezüglich des Gesamtüberlebens und der Lebensqualität von Patienten mit fortgeschrittener Erkrankung beobachtet. Mit Zulassung von Kombinationstherapien mit PD-(L)1(„programmed cell death protein 1“ [bzw. dessen Ligand])-Immuncheckpoint-Inhibitoren (ICI) als Erstlinientherapie im Jahr 2019 wurde die zuvor standardmäßig eingesetzte VEGFR(„vascular epidermal growth factor receptor“)-TKI(Tyrosinkinaseinhibitor)-Monotherapie als primäre Behandlung abgelöst. Neben der Immuntherapie mit Nivolumab und Ipilimumab sind mittlerweile vier VEGFR-TKI/ICI-Kombinationen zugelassen. Der Therapieauswahl sollte eine Risikostratifizierung anhand definierter Kriterien des International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) vorangehen. Klinische Parameter sowie eine ausführliche Beratung der Patienten zu Unterschieden im Effektivitätsprofil (Ansprechrate, langfristiges progressionsfreies Überleben), möglichen Nebenwirkungen und Auswirkungen auf die Lebensqualität helfen, eine individuelle Therapieentscheidung zu treffen und die Vorteile einer Strategie möglichst optimal zu nutzen.
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Metadaten
Titel
Risikostratifizierung und Therapiealgorithmus des metastasierten Nierenzellkarzinoms
verfasst von
Susan Foller
Katharina Leucht
Prof. Dr. med. Marc-Oliver Grimm
Publikationsdatum
02.12.2021
Verlag
Springer Medizin
Erschienen in
Die Onkologie / Ausgabe 2/2022
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-021-01062-y