Dtsch med Wochenschr 2017; 142(22): 1652-1659
DOI: 10.1055/s-0043-108467
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© Georg Thieme Verlag KG Stuttgart · New York

Präzisionstherapie beim kolorektalen Karzinom

Personalized Treatment for Colorectal CarcinomasSebastian Stintzing
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Publication History

Publication Date:
27 October 2017 (online)

Abstract

Colorectal carcinoma (CRC) is a major cause for cancer related death in Western countries. Particularly in the metastatic stage (mCRC) 5-year survival rate remains low at around 15 %. Treatment decisions are influenced by tumor stage, location of the primary, and extend of metastases. The multidisciplinary tumor board with an experienced hepato-biliary surgeon, an interventional radiologist, the medical oncologist, the molecular pathologist and the radiation oncologist will gain further importance in the quest for the optimal treatment for each patient. In the adjuvant setting, next to the established clinical risk factors, individualization especially for UICC-stage II patients can be done according to the CDX2-expression, the MSI-status, and perhaps the PIK3-status. In the metastatic stage, RAS and BRAF mutational analyses are pivotal to choose the best treatment for our patients. Primary tumor location in RAS-wild-type patients is further helping the clinician to tailor first-line treatment. Ongoing phase-III-trials will further help the clinician to come to a personalized decision.

Das kolorektale Karzinom (KRK) ist in Deutschland nach wie vor die zweithäufigste krebsbedingte Todesursache. Die Therapie besteht meist aus einer Kombination von Chirurgie, Strahlenmedizin und medikamentöser Therapie. Die Rolle der molekularen Pathologie wie auch die des interventionellen Radiologen gewinnt zunehmend an Bedeutung. Auch die Ergebnisse der Gensequenzierungs- und Genexpressionsanalysen sind für die Therapiefindung wichtig.