Zusammenfassung
Die Therapie von Patienten mit einem CUP-Syndrom (CUP:„cancer of unknown primary“) entsprechend dem Ursprungsgewebe ist Teil der Standardbehandlung, wenn sich in der Immunhistologie oder in der Kombination mit klinischen und laborchemischen Parametern große Ähnlichkeiten mit bekannten Tumoren erweisen. Auch mittels Genexpressions- oder Methylierungsanalysen können molekulare Ähnlichkeiten mit bekannten Tumoren nachgewiesen werden. Wenige retrospektive Untersuchungen scheinen einen Vorteil für Patienten zu zeigen, die eine Behandlung passend zu dem molekular definierten Tumor erhielten. Ein Nachweis der Überlegenheit einer auf eine solche Testung basierenden Therapiestrategie steht jedoch aus. Die Suche nach molekularen Zielen führt bei einem kleinen Teil der Patienten zur Möglichkeit der zielgerichteten Behandlung mit für andere Indikationen zugelassenen Medikamenten und kasuistischen Berichten über entsprechende Therapien.
Abstract
Treatment of patients with cancer of unknown primary (CUP) syndrome according to the tissue of origin is part of the standard care if the suspected original tumor is similar in immunohistochemistry or in combination with clinical and laboratory parameters. Gene expression analysis or methylation assays can demonstrate similarities of the CUP samples with known tumors. A few retrospective analyses seem to show an advantage for patients who received a therapy that matched with the molecularly defined tumor. Currently, the superiority of such a therapy based on the molecularly defined tissue of origin is not proven. The search for molecular targets leads in a small proportion of patients to the possibility of targeted therapy with drugs approved for other indications and published case reports on such treatment.
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G. Folprecht: Honorare für Vorträge/Advisory Boards von Merck-Serono, Roche/Genentech, Lilly, Sanofi-Aventis, Servier, Shire/Baxalta, Amgen, BMS, MSD, Mundipharma. Studienunterstützung: Merck-Serono.
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Folprecht, G. CUP – Therapie nach Molekularpathologie oder mit Immuntherapie. Onkologe 23, 1006–1010 (2017). https://doi.org/10.1007/s00761-017-0308-5
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DOI: https://doi.org/10.1007/s00761-017-0308-5