S3-Leitlinie Diagnostik und Therapie biliärer Karzinome – Kurzversion

Wesentliche Neuerungen

Die Langversion der S3-Leitlinie „Diagnostik und Therapie des Hepatozellulären Karzinoms und der biliären Karzinome“ umfasst zwei Tumorentitäten. Die letzte Version der Leitlinie wurde im August 2023 veröffentlicht.

Folgende wesentliche Änderungen ergeben sich bei den biliären Karzinomen zur S3-Leitlinie von 2023:

• Risikofaktoren (Kapitel 4.1): Das Lynch-Syndrom und BRCA-Keimbahnmutationen werden neu als Risikofaktoren benannt.

• Systemtherapie (Kapitel 4.5): 

  • Pembrolizumab wird als Alternative zu Durvalumab in der Kombination mit der Chemotherapie Gemcitabin/Cisplatin in der Erstlinie empfohlen.

  • Eine molekulare Charakterisierung des Tumors und eine Vorstellung im molekularen Tumorboard sollte spätestens bis zur Entscheidung über die Zeitlinientherapie erfolgen.

  • Patienten deren Tumoren eine Fibroblasten-Wachstumsfaktor-Rezeptor-2 (FGFR2) Fusion oder ein FGFR2-Rearrangement aufweisen wird ab der Zweitlinie alternativ zu Pemigatinib der FGFR-Inhibitor Futibatinib empfohlen.

Das Kapitel Supportivtherapie bezog sich schon in den vorherigen Versionen auf beide Tumorentiäten und wurde bei diesem Update nun an das Ende gestellt (Kapitel 4).

Eine detaillierte Übersicht der Änderungen befindet sich im Kapitel 6.2.

Publication History

Article published online:
07 February 2025

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