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Andrologische Beratung bei neuen onkologischen Systemtherapien mit „small molecules“

Andrological consultation in new systemic oncological therapies with small molecules

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Zusammenfassung

Die sog. „small molecules“ erweitern das Spektrum onkologischer Systemtherapien rasant. Zielproteine dieser Medikamentengruppe sind u. a. die Tyrosinkinasen VEGF(„vascular endothelial growth factor“)-R, EGF(„epidermal-growth-factor“)-R, Bcr-Abl, c‑kit, JAK („just another-kinase“, Januskinase), CDK („cycline dependent kinases“/cyclinabhängige Kinasen) u. a. In der Dermatologie gehören die Serin-Threonin-Kinasen BRAF und MEK beim Melanom und der Transmembranrezeptor SMO („smoothened“) beim Basalzellkarzinom dazu. Die Auswirkungen dieser zielgerichteten Therapien auf die männliche Fertilität sind z. T. nur unzureichend untersucht. Klinische Daten gibt es meist nur für die älteren Präparate. Darüber hinaus handelt es sich häufig um Multikinaseinhibitoren, sodass selbst „small molecules“ mit gleichem (Haupt‑)Target nicht vollständig vergleichbar sind. Bei unzureichender Datenlage sollte vor einer Therapie unter Berücksichtigung individueller Suszeptibilitätsunterschiede und andrologischer Vorerkrankungen eine Spermienkryokonservierung angeboten werden.

Abstract

Small molecules are rapidly broadening the spectrum of systemic oncologic therapies. Targets of those drugs are—among others—tyrosine and serine/threonine kinases like VEGF-R, EGF-R, Bcr-Abl, c‑kit, JAK, CDK as well as BRAF and MEK. Clinical data of potential risks to male fertility are still very limited and are generally only available for older preparations. In addition, they are often multikinase inhibitors, so that even small molecules with the same (main) target are not completely comparable. For fertility protection, sperm cryopreservation should be offered to men seeking fatherhood before starting targeted therapy.

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Abbreviations

ABL:

„Abelson murine leukemia viral oncogene homolog“

ALK:

Anaplastische Lymphomkinase

ATP:

Adenosintriphosphat

AXL:

Unkontrolliert (gr.: „anexelekto“)

BCR-ABL:

„Breakpoint cluster region – Abelson murine leukemia viral oncogene homolog“

BRAF:

„B-Rapidly growing fibrosarcoma“

CDK:

Cyclinabhängige Kinasen („cycline dependent kinases“)

c-MET:

„Hepatocyte growth factor (HGF) receptor“

EGF:

„Epidermal growth factor“

FGF-R:

„Fibroblast growth factor receptor“

FLT3:

„Fms-like tyrosine 3“

GnRH:

„Gonadotropin releasing hormone“

JAK:

„Just another-kinase“, Januskinase

MAPK:

„Mitogen activated protein kinase“

MEK:

„Mitogen-activated protein kinase kinase“

PDGF:

„Platelet-derived-growth-factor“

RAF‑1:

„Rapidly growing fibrosarcoma‑1“

RET:

„Rearranged during transfection“

SMO:

„Smoothened“

TIE2:

„TEK receptor tyrosine kinase“

VEGF:

„Vascular endothelial growth factor“

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Authors and Affiliations

  1. Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR, Ph.-Rosenthal-Str. 23, 04103, Leipzig, Deutschland

    Till Weidner, Uwe Paasch & Sonja Grunewald

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  1. Till Weidner
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  2. Uwe Paasch
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  3. Sonja Grunewald
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Correspondence to Till Weidner.

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Interessenkonflikt

T. Weidner, U. Paasch und S. Grunewald geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Weidner, T., Paasch, U. & Grunewald, S. Andrologische Beratung bei neuen onkologischen Systemtherapien mit „small molecules“. Hautarzt 69, 984–990 (2018). https://doi.org/10.1007/s00105-018-4299-y

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