Immunonkologie – ein Überblick

Abstract

Pioneering work has unraveled the role of the immune system in the development and control of cancer. This knowledge has set the basis for the successful implementation of immunotherapy into the standard of care for a large number of cancer types. Based on response rates and prolongation of overall survival, immunotherapeutic approaches have been approved in a growing number of tumor diseases. Activation or therapeutic utilization of T cells represent the basis of these concepts. Checkpoint inhibitory antibodies inhibiting CTLA-4, PD1 and PD-L1 receptors and ligands induce long-term clinical tumor control in a significant number of cancer patients including metastatic melanoma and non-small cell lung cancer. As an alternative concept of T cell activation, the dual CD19 – CD3 targeting bispecific antibody blinatumomab has been approved for refractory acute lymphatic B-cell leukemia (ALL). Moreover, T cells genetically engineered with an anti-CD19-chimeric antigen receptor have also been approved for ALL and malignant B-cell lymphoma by the food and drug administration (FDA). In all of these immunotherapies, severe side effects may occur and require a well-trained team of physicians. Moreover, the growing number of clinically investigated and validated novel compounds as well as cellular therapeutics accentuate the complexity and challenge of this treatment modality. This review highlights the most prominent recent clinical developments in the field of immuno-oncology.

Grundlegend für die Zulassung immunonkologischer Therapeutika war ein längeres Gesamtüberleben bei ansonsten nur sehr schwer behandelbaren Krebspatienten. Mittlerweile ist die Tumorimmuntherapie als fünfte Säule der Krebstherapie etabliert. Allerdings ist die Komplexität der neuen Substanzen und zellulären Therapeutika in Bezug auf die Wirkweise und mögliche Nebenwirkungen eine Herausforderung für den Behandler.

Schlüsselwörter

Immuntherapie - Zielstrukturen - Bispezifisch - T-Zellaktivierung - Tumormikromilieu

Key words

immunotherapy - target structures - bispecific - T-cell activation - tumor microenvironment

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