Neue Substanzen in der medikamentösen Therapie des nicht-kleinzelligen Lungenkarzinoms (NSCLC)

Zusammenfassung

Die medikamentöse Therapie des NSCLC hat in den letzen Jahren erkennbar an Bedeutung gewonnen. Neuere zytostatische Substanzen, wie z.B. Gemcitabin, Docetaxel, Paclitaxel, Vinorelbin und Pemetrexed haben die Entwicklung der zytostatischen Therapie entscheidend beeinflusst und beschleunigt. Weitere Verbesserungen in der medikamentösen Therapie verspricht man sich durch neue Substanzen, die summarisch als „targeted therapy” bezeichnet werden. Zu nennen sind hier aus einer großen Anzahl von Neuentwicklungen der EGFR-Tyrosinkinase-Inhibitor Erlotinib sowie die Multi-Tyrosinkinase-Inhibitoren ZD6474, Sorafinib und Sunitinib. Außerdem ist auf die monoklonalen Antikörper Cetuximab und Bevacizumab zu verweisen. Mit Bevacizumab konnte kürzlich gezeigt werden, dass sich bei ausgewählten Patienten mit fortgeschrittenem NSCLC bei Zugabe zur Standard-Chemotherapie die Überlebenszeit signifikant verlängern lässt. Immuntherapeutische Strategien und der Einsatz von Bisphosphonaten werden gegenwärtig beim NSCLC in Phase-III-Studien klinisch getestet.

Summary

In the last years, there has been a significant recognition in the application of drugs in the therapy of non-small cell bronchial carcinoma (NSCLC). The development of cytostatic therapy is decisively influenced and accelerated by new cytostatic substances including; gemcitabine, docetaxel, paclitaxel, vinorelbine and pemetrexed. Through “targeted therapy”, further improvement in drug therapy is expected from new substances. Examples include the new development of EGFR tyrosin-kinase inhibitor, erlotinib as well as multi-tyrosin-kinase inhibitors, ZD6474, sorafinib and sunitinib. The monoclonal antibodies cetuximab and bevacizumab are also significantly important. There is recent evidence of the application of bevacizumab on selected patients with advanced NSCLC. The patients' survival time was significantly elongated by the supplementation of bevacizumab to the standard chemotherapy. Currently, several immunotherapeutic strategies and the bisphosphonates in NSCLC are being clinically tested in phase III studies.

Schlüsselwörter

Nichtkleinzelliges Bronchialkarzinom - zytostatische Therapie - Bisphosphonate - targeted therapy - monoklonale Antikörper - Immuntherapie

Keywords

Non-small cell bronchial carcinoma - cytostatic therapy - bisphosphonate - targeted therapy - monoclonal antibodies - immunotherapy

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