{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T23:18:53Z","timestamp":1787613533709,"version":"build-2736575974"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"17","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Was ist neu?<\/jats:title>\n                  <jats:p>Die Subtypen des cholangiozellul\u00e4ren Karzinoms (CCC) unterscheiden sich u.a. im Vorhandensein molekularer Alterationen. Besonders das iCCC vom Small-Duct-Typ weist h\u00e4ufig therapeutisch relevante Ver\u00e4nderungen wie FGFR2-Fusionen und IDH1-Mutationen auf. Extrahepatische CCCs und Gallenblasenkarzinome zeigen h\u00e4ufiger HER2- und KRAS-Alterationen und gewinnen durch neue HER2-gerichtete Therapien sowie neuste Entwicklungen der KRAS-Inhibition zunehmend an Bedeutung.<\/jats:p>\n                  <jats:p>Beim fortgeschrittenen CCC sollte die molekulare Analyse idealerweise bereits bei Erstdiagnose beziehungsweise parallel zur Einleitung der Erstlinientherapie erfolgen. Da es unter der Erstlinientherapie zu einer raschen Krankheitsprogression kommen kann, sollten zielgerichtete Therapieoptionen der Zweitlinie fr\u00fchzeitig detektiert worden sein. Vor allem f\u00fcr FGFR2-, NTRK, NRG1- und RET-Fusionen ist daher eine fusionssensitive Analytik mit RNA-Komponente von gro\u00dfer Bedeutung.<\/jats:p>\n                  <jats:p>Es gibt bislang keine etablierten Biomarker, die das Ansprechen auf die Chemoimmuntherapie beim CCC verl\u00e4sslich vorhersagen k\u00f6nnen. Translationale Ans\u00e4tze wie die Analyse des Tumormikromilieus und r\u00e4umlicher Immunprofile r\u00fccken zunehmend in den Fokus. Kommt es zu einem Progress unter der Erstlinie, richtet sich die weitere Therapiestrategie zunehmend nach dem molekularen Profil.<\/jats:p>\n                  <jats:p>Mit Zanidatamab steht f\u00fcr vorbehandelte HER2-positive bili\u00e4re Karzinome mit einem IHC-Score von 3+ eine neue zielgerichtete Option in der Zweitlinie zur Verf\u00fcgung. Trastuzumab-Deruxtecan wird von der EMA f\u00fcr vorbehandelte, nicht resektable oder metastasierte HER2-positive solide Tumoren mit IHC 3+ empfohlen. Die laufende Phase-III-Studie HERIZON-BTC-302 pr\u00fcft, ob eine HER2-gerichtete Strategie bereits in der Erstlinie zus\u00e4tzlichen Nutzen bietet.<\/jats:p>\n                  <jats:p>Pr\u00e4zisionsonkologie ist beim CCC klinische Realit\u00e4t, ihre Umsetzung bleibt jedoch optimierungsbed\u00fcrftig. Entscheidend sind eine fr\u00fche Testung aller Patient*innen mit fortgeschrittener Erkrankung, methodisch vollst\u00e4ndige Diagnostik einschlie\u00dflich RNA-basierter Fusionsanalytik, zeitgerechte Befundverf\u00fcgbarkeit und die interdisziplin\u00e4re Bewertung im molekularen Tumorboard.<\/jats:p>","DOI":"10.1055\/a-2615-7493","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T22:32:26Z","timestamp":1787610746000},"page":"940-947","source":"Crossref","is-referenced-by-count":0,"title":["Cholangiozellul\u00e4res Karzinom als Modellerkrankung: Neue Wege in der personalisierten Medizin"],"prefix":"10.1055","volume":"151","author":[{"given":"Maryam","family":"Barsch","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum Freiburg","place":["Freiburg"],"department":["Klinik f\u00fcr Innere Medizin II, Gastroenterologie, Hepatologie, Endokrinologie und 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