Biologische zielgerichtete („targeted”) Therapien haben den Weg vom Labor in die Klinik gefunden. Durch die Identifizierung biologischer Zielstrukturen mit ihren Signaltransduktionswegen konnten spezifische Therapieverfahren entwickelt werden. In der Zweit- und Drittlinientherapie gehören die EGFR-Thyrosinkinasen-Inhibitoren als „targeted therapies” zum Standard beim nicht kleinzelligen Lungenkarzinom (NSCLC), die VEGF-Antikörper konnten sich in einer Phase-III-Studie in der Erstlinientherapie des NSCLC als besser als eine alleinige Chemotherapie wirksam platzieren, und in allen anderen Indikationen und Stadien laufen klinische Studien.
Wesentlicher Vorteil ist eine gute Verträglichkeit und die zum Teil orale Gabe der Therapie.
Die einzelnen Zielstrukturen und die gegen sie gerichteten Medikamente werden vorgestellt und ihr Stellenwert beim Lungenkarzinom diskutiert.
Abstract
An increased understanding of the biology of lung cancer has identified biological targets for rationally designed novel therapies. Most of these targets are components of signalling pathways or metabolic processes. EGFR-tyrosinkinase inhibitors have become standard in second- and thirdline therapy of NSCLC, the anti-VEGF-antibody Avastin combined with first-line chemotherapy showed a significant survival benefit over chemotherapy alone. There are ongoing studies with targeted therapies in all stages of lung cancer.
Major advances of these new drugs are their low toxicity and, in part, the oral application.
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