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Aktuelle Urol 2009; 40(1): 27-30
DOI: 10.1055/s-0028-1098786
Konsensuskonferenz

© Georg Thieme Verlag Stuttgart ˙ New York

Interdisziplinäre Empfehlungen zur Behandlung des metastasierten Nierenzellkarzinoms

Interdisciplinary Recommendations for the Treatment of Metastatic Renal Cell CarcinomaK. Miller1 , L. Bergmann2 , E. Jäger3 , G. Jakse4 , M. Wirth5 , U. Keilholz6 für die interdisziplinäre Arbeitsgruppe Nierenzellkarzinom der Deutschen Krebsgesellschaft e. V. (DKG)
  • 1Klinik für Urologie, Charité – Universitätsmedizin Berlin
  • 2Medizinische Klinik II, J. W. Goethe-Universität Frankfurt / Main
  • 3Medizinische Klinik II, Krankenhaus Nordwest, Frankfurt / Main
  • 4Urologische Klinik, RWTH Aachen
  • 5Klinik und Poliklinik für Urologie, Universitätsklinikum Carl Gustav Carus, Dresden
  • 6Medizinische Klinik III, Charité – Universitätsmedizin Berlin
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Publication History

Publication Date:
28 January 2009 (online)

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Zusammenfassung

Mit der Einführung zielgerichteter Substanzen hat die Therapie des metastasierten Nierenzellkarzinoms einen Paradigmenwechsel erfahren: Der Einsatz von Zytokinen als langjährige Standardtherapie rückte in den Hintergrund, neue Medikamente wie Sunitinib, Sorafenib, Bevacizumab und Temsirolimus haben sich als Behandlungsstandard etabliert. Welche Kriterien beim Einsatz dieser Substanzen zu berücksichtigen sind und welche Fragen auf Basis der aktuellen Studienlage noch unbeantwortet bleiben, war Gegenstand einer Konsensuskonferenz. Das interdisziplinäre Board knüpfte an Therapieempfehlungen aus dem Jahr 2007 an [22]. Das Ergebnis der Diskussion wird hier in Form von Thesen zusammengefasst.

Abstract

With the introduction of targeted therapies, a paradigm shift for the treatment of metastatic renal cell cancer has taken place. New compounds like sunitinib, sorafenib, bevacizumab and temsirolimus have become established as new therapeutic standards. An interdisciplinary consensus conference was held to discuss treatment sequences and open questions. Results from the 2007 conference [22] provided the basis for the 2008 meeting. The results of the 2008 conference are presented as short theses.

Schlüsselwörter

Nierenzellkarzinom - Metastasen - medikamentöse Therapie - gezielte Therapie

Key words

renal cell cancer - metastases - medical treatment - targeted Therapy

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1 Memorial Sloan-Kettering Cancer Center (MSKCC) Risikofaktoren:
– niedriges Hämoglobin (< Normwert)
– erhöhtes korrigiertes Kalzium (> 10 mg / dl)
– erhöhte Laktatdehydrogenase (> 1,5-facher Normwert)
– schlechter Performance-Status (Karnofsky < 80 %)
– Zeit von der Erstdiagnose bis zur Behandlung < 1 Jahr
MSKCC-Risikogruppen zur Abschätzung des Progressionsrisikos:
– Risikogruppe 1 (niedriges Risiko) = 0 Risikofaktoren
– Risikogruppe 2 (mittleres Risiko) = 1 oder 2 Risikofaktoren
– Risikogruppe 3 (hohes Risiko) = 3–5 Risikofaktoren

Prof. Dr. med. K. Miller

Charité – Campus Benjamin Franklin · Urologische Klinik und Hochschulambulanz

Hindenburgdamm 30

12200 Berlin

Email: kurt.miller@charite.de