„Liquid biopsy“: Analyse molekularer Marker aus Blutproben zur Therapiesteuerung beim Lungenkarzinom

Wolfgang M. Brückl; R. M. Wirtz; T. Bertsch; J. H. Ficker; A. Jung

doi:10.1055/a-0604-4329

TumorDiagnostik & Therapie, Table of Contents

TumorDiagnostik & Therapie 2018; 39(06): 385-397
DOI: 10.1055/a-0604-4329

Thieme Onkologie aktuell

„Liquid biopsy“: Analyse molekularer Marker aus Blutproben zur Therapiesteuerung beim Lungenkarzinom

Liquid biopsy: detection of molecular markers for treatment decisions in lung cancer

Wolfgang M. Brückl

¹Universitätsklinik für Pneumologie, Allergologie und Schlafmedizin, Paracelsus Medizinische Privatuniversität, Nürnberg

²Medizinische Klinik 3 (Pneumologie, Allergologie, Schlafmedizin), Klinikum Nürnberg, Nürnberg

,

R. M. Wirtz

³Institut für Pathologie, St. Elisabeth Krankenhaus, Köln

⁴STRATIFYER Molecular Pathology GmbH, Köln

,

T. Bertsch

⁵Universitätsinstitut für Klinische Chemie, Laboratoriumsmedizin und Transfusionsmedizin – Zentrallaboratorium, Paracelsus Medizinische Privatuniversität, Nürnberg

⁶Institut für Klinische Chemie, Laboratoriumsmedizin und Transfusionsmedizin – Zentrallaboratorium, Klinikum Nürnberg, Nürnberg

,

J. H. Ficker

¹Universitätsklinik für Pneumologie, Allergologie und Schlafmedizin, Paracelsus Medizinische Privatuniversität, Nürnberg

²Medizinische Klinik 3 (Pneumologie, Allergologie, Schlafmedizin), Klinikum Nürnberg, Nürnberg

,

A. Jung

⁷Pathologisches Institut der Ludwig-Maximilian-Universität München

› Author Affiliations

Abstract

Zusammenfassung

Zielgerichtete Therapien haben erfolgreich Einzug in die palliative Therapie des Lungenkarzinoms gehalten, da sie eine Individualisierung oder Personalisierung ermöglichen, die mit der Testung von prädiktiven Biomarkern einhergeht. Dadurch steigt die Zahl an prädiktiven molekularbiologischen und immunhistochemischen Untersuchungsmöglichkeiten zu verschiedenen Zeitpunkten der Therapie und damit der Bedarf an jeweils aktuellen Tumorgewebeproben. Diese sind jedoch oft nicht ohne unverhältnismäßig hohe Belastungen für den Patienten zu gewinnen. Daher stellen Verfahren der Diagnostik aus Blutproben, die mit dem aus dem Englischen stammenden Begriff „liquid biopsy“ zusammengefasst werden, eine Alternative bzw. Ergänzung zur klassischen Gewebebiopsie dar. Derzeit können in der klinischen Routine bereits aktivierende EGFR-Mutationen sowie die inhibitorische Mutation T790 M aus dem Blut detektiert werden. Dieser Artikel stellt den aktuellen Stellenwert der liquid biopsy in der Diagnostik, zur Prognose und zur Steuerung des Therapieverlaufs bei Lungenkarzinomen dar und gibt einen Ausblick auf zukünftige Möglichkeiten.

Abstract

Personalized, individualized, targeted therapy has successfully found entrance in the palliative treatment of lung cancer as they enable a personalized and individualized strategy going ahead with biomarker testing. Due to the crescending amount of predictive molecular and immunhistochemical analyses at different time points during therapy the need for more and actual tumor tissue increases; however these samples cannot always be obtained without major discomfort for the patients. Therefore, analyses from blood, the so called „liquid biopsy“, is an alternative or additional method. Activating mutations in the EGFR gene and the inhibitory mutation T790 M can already be detected from blood during clinical routine. This review presents the status of liquid biopsy for diagnosis, prognosis and as predictive parameter during the course of therapy in lung cancer and gives an outlook on future developments.

Full Text

References

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