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Deutsche Zeitschrift für Onkologie 2009; 41(4): 159-162
DOI: 10.1055/s-0029-1242549
Forschung

© Karl F. Haug Verlag in MVS Medizinverlage Stuttgart GmbH & Co. KG

Spezifische Immuntherapie bei Nierenzellkarzinomen

Jan Neßelhut1 , Dagmar Marx2 , Thomas Neßelhut1
  • 1Institut für Tumortherapie, Duderstadt
  • 2Gesellschaft für Dendritic-cell Therapie mbH
Further Information

Publication History

Publication Date:
04 January 2010 (online)

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See also:

Innovative zielgerichtete Therapie des fortgeschrittenen NierenzellkarzinomsDeutsche Zeitschrift für Onkologie 2009; 41(04): 152-157
DOI: 10.1055/s-0029-1242532

Zusammenfassung

Die Prognose von fortgeschrittenen Nierenzellkarzinomen ist nach wie vor infaust. Die mediane Überlebenszeit für das metastasierte Stadium liegt unter einem Jahr. Da bei Nierenzellkarzinomen im Vergleich zu anderen Tumoren häufiger Spontanremissionen beobachtet werden, liegt die Vermutung nahe, dass das Nierenzellkarzinom prinzipiell auf eine immunologische Therapie anspricht. Dabei zeigten sich die Standardtherapieverfahren der unspezifischen Immuntherapie mit Interferonen und Interleukin-2 als nicht besonders erfolgversprechend hinsichtlich der Verlängerung der Gesamtüberlebenszeit bei gleichzeitig nicht zu unterschätzenden Nebenwirkungen. Daher ist die Entwicklung innovativer Strategien auf der Basis zellulärer spezifischer Immuntherapien, insbesondere für das fortgeschrittene Stadium, von eminent wichtiger Bedeutung. Dies gilt insbesondere unter Berücksichtigung der Verbesserung oder wenigstens Beibehaltung der Lebensqualität. Mittlerweile liegen für das Nierenzellkarzinom eindeutige Hinweise vor, dass es in besonderem Maße durch eine T-Zell-vermittelte Immunantwort behandelbar ist. In mehreren klinischen Phase-I/II-Studien sowie Einzelfallbeschreibungen konnte gezeigt werden, dass die Behandlung von Nierenzellkarzinomen mit einer spezifischen, zellbasierten Immuntherapie erfolgreich sein kann. Dabei wurden autologe Tumorvakzinen, Peptidvakzinen sowie autologe dendritische Zellen zur Behandlung eingesetzt. Die Therapien wurden allgemein gut vertragen, schwerwiegende Nebenwirkungen wurden für keine der Vakzinierungsstrategien beschrieben.

Summary

Advanced renal cell carcinomas belong to the tumors with up to now unfavorable prognosis. Once metastasized the median survivals are less than one year. Because of observed spontaneous remissions of metastases it is likely that an immunotherapy can be a successful treatment option. However, the treatment with an unspecific immunotherapy with Interferon or Interleukine-2 failed to have a significant impact on the survival and the side effects are high. Thus the development of a specific immunotherapy is required. Meanwhile, several groups have shown that a specific immunotherapy based on cellular vaccines can induce a clinical antitumor response in patients with renal cell carcinoma, especially in advanced metastatic disease stages.

Schlüsselwörter

Nierenzellkarzinom - dendritische Zelle - Immuntherapie - Tumorzell-Lysat - regulatorische T-Zellen (T-reg) - TLR

Keywords

Renal cell carcinoma - dendritic cell - immunotherapy - cellular vaccines - regulatoric T-Cells

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Korrespondenzadresse

Dr. Thomas Neßelhut

Institut für Tumortherapie

Hinterstrasse 53

37115 Duderstadt

Email: thomas.nesselhut@dr-nesselhut.de

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