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Aktuelle Urol 2022; 53(02): 167-179
DOI: 10.1055/a-1779-8764
Übersicht

Update Systemtherapie des Urothelkarzinoms – Therapie im Wandel

Update on systemic treatment of urothelial cancer: therapy in transition
Robert Tauber
1   Klinik und Poliklinik für Urologie, Klinikum rechts der Isar, Technische Universität München, München, Germany
,
Gunhild von Amsberg
2   Onkologisches Zentrum/ Martini-Klinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany (Ringgold ID: RIN37734)
,
Maria De Santis
3   Klinik für Urologie, Charité Universitätsmedizin Berlin, Berlin, Germany (Ringgold ID: RIN14903)
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Zusammenfassung

Die systemische Behandlung des lokal fortgeschrittenen und metastasierten Urothelkarzinoms verändert sich seit wenigen Jahren in einem atemberaubenden Tempo. Zentraler Bestandteil der perioperativen Therapien und der Erstlinienbehandlung im metastasierten Stadium ist aber weiterhin die Platin-basierte Chemotherapie. Immuntherapien mit Immuncheckpoint-Inhibitoren sind inzwischen fester Bestandteil der Therapiealgorithmen. Neue, zielgerichtete Formen der Chemotherapie stehen kurz vor der Zulassung. Fortschritte beim Verständnis der molekulargenetischen Analyse von Tumorgewebe werden in Kürze personalisierte Therapieoptionen ermöglichen.

Der vorliegende Artikel soll einen Überblick über die aktuellen systemischen Therapieoptionen und die zugrunde liegende Datenbasis geben. Neue Entwicklungen sollen aufgezeigt werden, indem laufende Phase-III-Studien vorgestellt werden. Nach lesen des Artikels soll der Leser sich über den aktuellen Stand der systemischen Therapie des Urothelkarzinoms informiert fühlen.

Abstract

The systemic treatment of locally advanced and metastatic urothelial carcinoma has been changing at a breathtaking pace for a few years. However, platinum-based chemotherapy continues to be the central component of perioperative therapies and first-line treatment in the metastatic stage. Immunotherapies with immune checkpoint inhibitors are now an integral part of therapy algorithms. New targeted forms of chemotherapy are about to be approved. Advances in understanding the molecular genetic analysis of tumour tissue will soon enable personalised therapy options.

This article is intended to provide an overview of current systemic therapy options and the underlying database. New developments are identified by presenting ongoing phase III trials. After reading this article, the reader should feel informed about the current status of systemic therapy for urothelial carcinoma.

Schlüsselwörter

Urothelkarzinom - Blasenkarzinom - Tumore des oberen Harntrakts - Chemotherapie - Immuntherapie

Keywords

bladder cancer - upper tract urinary cancer - immunotherapy - urothelial cancer - perioperative therapy


Publication History

Received: 20 September 2021

Accepted after revision: 14 February 2022

Article published online:
28 March 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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