Zusammenfassung
In den letzten Jahrzehnten erzielte die Immuntherapie des Kolonkarzinoms erste wissenschaftliche
Fortschritte und entwickelte sich von einer unspezifischen Immunverstärkung über die
„aktive spezifische Immuntherapie” zum gezielten immunologischen „Targeting”. Auch
wenn Therapieansätze zur Vakzination mit Antigenen oder viralen Vektoren positive
Daten zeigen, fehlt der klare Beleg der klinischen Wirksamkeit in großen randomisierten
Phase-III-Studien. Parallel werden allgemein anerkannte Analysemethoden benötigt,
die bei Patienten die Entwicklung einer therapeutisch effektiven Immunantwort belegen
und so die bisher unterschiedlichen Endpunkte in Phase-I/II-Studien vergleichbar machen.
Aktuell sind in der palliativen Therapie nur zwei spezifische Antikörper der Rezeptor-Ligandenfamilien
der EGF- und VEGF-Signalwege zugelassen, deren immunologische Bedeutung ihrer antikörperabhängigen
zellulären Zytotoxizität derzeit analysiert wird.
Abstract
The specific immunotherapy of colorectal cancer initially revealed promising results.
However, a significant clinical benefit for patients has still to be proven in phase
III trails. In order to compare the different clinical approaches and early phase
I - II studies, there is an urgent need for the establishment and acceptance of new
standardized diagnostic tools for detecting and quantifying induced and clinical relevant
immune responses in patients. Whether or not subgroups with a certain genetic background,
such as specific HLA alleles, reveal a better benefit from tumour vaccinations needs
to be further analysed. Currently, only two specific antibodies, targeting membraneous
receptors or their ligands, such as EGF or VEGF, have been approved by diverse national
drug authorities. The question as to whether these antibodies also induce an antibody-dependent
cellular toxicity (ADCC) is currently being analysed.
Schlüsselwörter
Kolorektales Karzinom - Immuntherapie - Studien
Key words
Colorectal cancer - clinical trials - immunotherapy
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PD Dr. med. Markus Möhler
1. Medizinische Klinik und Poliklinik, Johannes-Gutenberg-Universität, Mainz
Langenbeckstr. 1
55101 Mainz
Phone: ++49/61 31/1 70
Fax: ++49/61 31/17 34 38
Email: moehler@mail.uni-mainz.de
