Diätetische Ansätze in der Tumortherapie

Zusammenfassung

Im Zuge der personalisierten Medizin gewinnen bei Tumorerkrankungen patientenindividuelle Faktoren wie persönliche Ernährungsmuster, der Lebensstil, das intestinale Mikrobiom oder das Geschlecht immer mehr an Bedeutung. Neben anderen Tumorentitäten erlangt auch beim malignen Melanom die Ernährung einen zunehmenden Stellenwert. Durch die Einführung der immun- und zielgerichteten Therapien konnte die Mortalität zwar deutlich gesenkt werden, jedoch zeigt sich ein sehr heterogenes Therapieansprechen. Folglich ist das Bestreben groß, alternative oder unterstützende Faktoren für ein besseres Therapieansprechen zu identifizieren. Präklinische Studien konnten bereits positive Effekte diätetischer Interventionen auf eine Immuntherapie und in der Folge auf das Therapieansprechen zeigen. Z.T. konnte das Ansprechen auf eine Immuntherapie sogar wiederhergestellt werden. Dabei wird angenommen, dass der Zellmetabolismus durch eine bestimmte Nährstoffaufnahme „umprogrammiert“ werden kann. Um diese präklinischen Daten auf die Klinik zu transferieren, werden im Rahmen von klinischen Studien diätetische Interventionen in Kombination mit etablierten Tumortherapien untersucht und dabei deren Auswirkungen auf den Metabolismus der Tumor- und Immunzellen analysiert.

Abstract

In the course of personalized medicine, patient-specific factors such as personal dietary habits, lifestyle, gut microbiome or gender are becoming more and more relevant in the treatment of tumor diseases. Beside other tumor entities, nutrition are becoming increasingly important in malignant melanoma. The introduction of immunotherapy and targeted therapies has significantly reduced mortality, but the response to treatment is often heterogeneous. Therefore, great efforts are being made to identify alternative or supportive factors that may lead to an improved therapy response. Preclinical studies have already shown the positive effects of dietary interventions on immunotherapy and therapy response. In some cases, the response to immunotherapy can be even reversed. It is assumed that the cellular metabolism is ‘reprogrammed’ by specific nutrient intake. In order to translate these pre-clinical data to the clinic, an increasing number of clinical trials are being initiated to assess specific nutritional interventions in combination with established tumor therapies and their effects on the metabolism of tumor cells and immune cells.

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