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Aktuelle Urol 2010; 41(3): 193-196
DOI: 10.1055/s-0030-1247395
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 , P. Albers3 , J. Gschwend4 , E. Jäger5 , U. Keilholz6
  • 1Klinik für Urologie, Charité – Universitätsmedizin Berlin
  • 2Medizinische Klinik II, J. W. Goethe-Universität Frankfurt / Main
  • 3Klinik für Urologie Universitätsklinikum Düsseldorf
  • 4Urologische Klinik und Poliklinik der Technischen Universität München Klinikum rechts der Isar
  • 5Medizinische Klinik II, Krankenhaus Nordwest, Frankfurt / Main
  • 6Medizinische Klinik III, Charité – Universitätsmedizin Berlin
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Publication History

Publication Date:
18 May 2010 (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. Seit Mitte 2009 werden diese Substanzen durch Everolimus ergänzt. Welche Kriterien beim Einsatz dieser Medikamente 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 2008 an [1]. 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 carcinoma has taken place. The use of cytokines as the long-standing standard therapy has declined. New compounds like sunitinib, ­sorafenib, bevacizumab and temsirolimus have become established as new therapeutic standards. Since mid-2009, these substances have been complemented by everolimus. An interdisciplinary consensus conference was held to discuss what criteria to consider when using these drugs (treatment sequence) and what questions remain unanswered based on the current study situation (open questions). Results from the 2008 confer­ence provided the basis for the 2009 meeting. The results of the 2009 conference are presented as short theses.

Schlüsselwörter

Nierenzellkarzinom - medikamentöse Therapie - zielgerichtete Therapie

Key words

renal cell cancer - 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 · Urologische Klinik und Hochschulambulanz

Hindenburgdamm 30

12200 Berlin

Email: Kurt.miller@charite.de

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