Therapie des Pankreaskarzinoms – und sie bewegt sich doch!

Zusammenfassung

Voraussagen zufolge wird 2030 das duktale Pankreaskarzinom die dritthäufigste tumorbedingte Todesursache sein. Dies ist einer wachsenden Inzidenz und Fortschritten in Prävention und Therapie anderer Tumorentitäten geschuldet. Das Pankreaskarzinom ist eine meist (zu) spät diagnostizierte Erkrankung: Etwa 80 % der Patienten sind nach Diagnose der Erkrankung aufgrund lokaler Irresektabilität oder Fernmetastasierung nicht mehr kurativ operabel. Auch nach R0-Resektion und adjuvanter Chemotherapie liegt die 5-Jahresüberlebensrate bei nur 20 %. Bei der der Behandlung des metastasierten Pankreaskarzinoms wurden deutliche Fortschritte erzielt. Neue Therapieoptionen ermöglichen erstmalig, die Therapie zu differenzieren. Auch das Spektrum an Folgetherapien nach Versagen der Erstlinientherapie erweitert sich. Nach Jahren der Stagnation und negativer Studienergebnisse begeistern diese Fortschritte und wirken sich dynamisierend auf die Studienlandschaft aus.

Abstract

According to predictions pancreatic ductal adenocarcinoma will be the third most common cancer-related cause of death in 2030 due to its growing incidence and advances in prevention and treatment of other tumor entities. Pancreatic cancer is usually a (too) late diagnosed disease. Already at time of primary diagnosis nearly 80 % of patients have palliative disease due to local irresectability or distant metastases. Even after R0 resection of the primary tumor followed by adjuvant chemotherapy the 5-year overall survival rate does not exceed 20 %. Recently the treatment landscape has significanty changed in metastatic pancreatic cancer. For the first time, we have the opportunity to personalize our therapies in the field of pancreatic cancer. In addition, the range of therapeutic options after failure of first-line treatment expands more and more. After years of stagnation and negative results in clinical trials these advances inspire and dynamize the landscape of new clinical trials in this entity.

Schlüsselwörter

Pankreaskarzinom - Systemtherapie - FOLFIRINOX - nab-Paclitaxel - Gemcitabin - nal-Irinotecan

Keywords

pancreatic cancer - chemotherapy - FOLFIRINOX - nab-Paclitaxel - Gemcitabine - nal-Irinotecan

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