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Immuntherapie des HNSCC

Quo vadis?

Immunotherapy for HNSCC

Quo vadis?

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Zusammenfassung

Hintergrund

Die Entwicklungen in der Immuntherapie für Plattenepithelkarzinome des Kopf-Hals-Bereichs („head and neck squamous cell carcinoma“, HNSCC) ist sehr dynamisch und die Anzahl der neu initiierten Studien seit mehreren Jahren beeindruckend hoch. Die Ergebnisse bisheriger Studien sind in der palliativen Zweitlinientherapie für HNSCC vielversprechend und es werden nun Anwendungen in der palliativen Erstlinie sowie der kurativen Therapie getestet. Hierbei gibt es Konzepte für die primär nichtchirurgische, die adjuvante sowie die neoadjuvante Behandlung mit Immunmodulatoren. Die bislang verwendeten Biomarker reichen allerdings noch nicht aus, um eine exakte Prädiktion für das Therapieansprechen zu generieren.

Ziel der Arbeit

Anlässlich des diesjährigen Meetings der American Society of Clinical Oncology (ASCO) wird ein Ausblick über die in den nächsten Jahren zu erwartenden Entwicklungen im Feld der Immuntherapie gegeben.

Methoden

Ausgehend von den auf dem ASCO-Meeting 2016 präsentierten kommenden Studien wurde eine Übersicht über die zukünftigen Anwendungen der Immuntherapie erstellt.

Ergebnisse

Insbesondere die Suche nach prädiktiven Biomarkern steht im Fokus der Forschung für die nächsten Jahre. Zahlreiche neue Substanzen drängen auf den Markt und werden in klinischen Studien erprobt. Zunehmend werden nun auch Kombinationen aus verschiedenen Checkpointinhibitoren mit Chemotherapeutika, Bestrahlung und Antikörpern erprobt.

Schlussfolgerung

Für den optimalen Einsatz der neuen Immuntherapeutika fehlen bisher verlässliche Kriterien für die Patientenauswahl. Daher müssen Biomarker identifiziert werden, die diese Prädiktion möglich machen können.

Abstract

Background

Immunotherapy remains a hot topic with an endless stream of new upcoming clinical trials. The results of studies to date are promising for second-line palliative treatment of head and neck squamous cell carcinoma (HNSCC). The next step is testing these strategies in randomized trials for first-line and curative treatment in an adjuvant, neoadjuvant, and primarily nonsurgical setting. So far, established biomarkers have not proven reliable enough to predict response rates precisely.

Objectives

On occasion of the annual meeting of the American Society of Clinical Oncology (ASCO), we aimed to invesitage the future of immunotherapies.

Methods

We collected the most promising upcoming studies alongside current research in the field of biomarkers with a  view to interesting new immunotherapeutic strategies.

Results

The search for appropriate biomarkers in particular seems to be a central research objective in the short term. There is a broad range of new agents that will be tested in clinical trials as well as the combination of immunotherapy with chemo- and chemoradiotherapy or other immune-modulating drugs.

Conclusion

The real challenge will be to find the most fitting therapy for each patient out of a large panel of available regimens. Therefore, it is most important to find a set of reliable biomarkers that together could predict treatment response.

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Authors and Affiliations

  1. Klinik für Hals-Nasen-Ohrenheilkunde und Kopf-Hals-Chirurgie, Universitätsklinik Ulm, Frauensteige 12, 89070, Ulm, Deutschland

    J. Döscher, P. J. Schuler & S. Laban

  2. Klinik für Hals-Nasen-Ohrenheilkunde und Kopf-Hals-Chirurgie und Onkologie, Kopf-Hals-Tumorzentrum des UCCH, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    C.-J. Busch

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  1. J. Döscher
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  2. C.-J. Busch
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  3. P. J. Schuler
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  4. S. Laban
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Correspondence to J. Döscher.

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Interessenkonflikt

S. Laban hat an einem Advisory Board Meeting von Astra Zeneca teilgenommen. J. Doescher, C.-J. Busch und P. J. Schuler geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Döscher, J., Busch, CJ., Schuler, P.J. et al. Immuntherapie des HNSCC . HNO 64, 700–707 (2016). https://doi.org/10.1007/s00106-016-0241-8

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