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Blasenkarzinomsystemtherapie

Systemic treatment of bladder cancer

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Zusammenfassung

Die Cisplatin-basierte Polychemotherapie stellt in der Systemtherapie des muskelinvasiven Harnblasenkarzinoms („muscle-invasive bladder cancer“, MIBC) seit langer Zeit den Therapiestandard dar. In den vergangenen Jahren haben sich zudem auch Immun-Checkpoint-Inhibitoren (ICI) als Therapiealternative bei Cisplatin-ungeeigneten Patienten und in der Therapiesequenz des metastasierten Urothelkarzinoms etabliert. In diesem Artikel sollen die verfügbare Literatur und aktuelle Leitlinien anhand von zwei Patientenbeispielen aufgearbeitet werden, um so Therapieentscheidungen und Behandlungspfade in der Systemtherapie des lokal begrenzten und metastasierten Urothelkarzinoms der Harnblase aufzuzeigen und praxisrelevante Inhalte zu vermitteln.

Abstract

Cisplatin-based chemotherapy regimens represent the standard of care in patients with locally advanced or metastatic urothelial carcinoma of the bladder. However, many patients are ineligible for cisplatin due to comorbidities or performance status. Immunotherapy with checkpoint inhibitors (CPI) has become a well-established treatment alternative in metastatic bladder cancer. The following review discusses current literature and guideline recommendations based on two case studies, in order to provide practical know-how about therapy sequences and treatment processes.

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  1. Klinik für Urologie, Universität Regensburg, Caritas Krankenhaus St. Josef, Landshuter Straße 65, 93053, Regensburg, Deutschland

    M. Haas, M. Burger & M. J. Schnabel

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  1. M. Haas
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Correspondence to M. Haas.

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M. Burger und M.J. Schnabel: Beratertätigkeit und Vorträge für Merck, BMS, Roche und Durchführung von Studien für MSD. M. Haas gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Haas, M., Burger, M. & Schnabel, M.J. Blasenkarzinomsystemtherapie. Urologe 60, 1167–1174 (2021). https://doi.org/10.1007/s00120-021-01535-3

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