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Lungenkarzinom

Molekulare Pathologie und personalisierte Therapie

Lung cancer

Molecular pathology and personalized therapy

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Zusammenfassung

Die Tumorimmuntherapie hat in den letzten Jahren rasante Fortschritte gemacht. So lieferten Studien zur Behandlung des Bronchialkarzinoms mit „cancer vaccines“ wie dem melanomassoziierten Antigen A3 (MAGE-A3) und liposomalem BLP25 vielversprechende Ergebnisse in den Stadien IB/II und III des nichtkleinzelligen Bronchialkarzinoms. Immunmodulatorische Agenzien wie Talactoferrin oder Ipilimumab scheinen v. a. in Verbindung mit einer platinbasierten Chemotherapie zu wirken, was andeutet, dass insbesondere die Kombination von Immuntherapeutika, konventioneller Chemotherapie und tumorspezifischen, zielgerichteten Agenzien das größte therapeutische Zukunftspotenzial besitzt. Das genaue Verständnis der Interaktion zwischen Tumor und Immunsystem bleibt essenziell für die Identifizierung potenzieller Biomarker. Im Idealfall ermöglicht es auch im Bereich der Immuntherapie die Entwicklung gezielter Ansätze.

Abstract

Recent advances in the treatment of non-small cell lung cancer (NSCLC) are based on the identification of so-called driver mutations, resulting in a more personalized treatment setting. Currently about 15 % of NSCLC patients benefit from improved treatment protocols based on the genetic background of the tumor. In the last few years cancer immunotherapy has returned to the center of attention and comprises a variety of treatment approaches incorporating adaptive, as well as innate immunity. Current strategies involve the use of monoclonal antitumor antibodies, cancer vaccines, adoptive transfer of ex vivo activated T and NK cells as well as the blockade of so-called immune checkpoints (immune inhibitory pathways). Especially the combination of current treatments with immunotherapy seems promising to achieve highly potent antitumor effects. However, a profound understanding of the dynamic and complex interaction between lung cancer and the host immune system and especially its immune checkpoints is the foundation to identify potential biomarkers for a personalized cancer immunotherapy approach.

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Authors and Affiliations

  1. Institut für Pathologie, CIO Köln Bonn, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Köln, Deutschland

    A. Schultheis & R. Büttner

  2. Klinik für Innere Medizin I, CIO Köln Bonn, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Köln, Deutschland

    J. Wolf

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  1. A. Schultheis
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  2. J. Wolf
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  3. R. Büttner
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Correspondence to A. Schultheis.

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Schultheis, A., Wolf, J. & Büttner, R. Lungenkarzinom. Internist 54, 179–187 (2013). https://doi.org/10.1007/s00108-012-3151-1

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