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Immuntherapie beim Nierenzellkarzinom

Immunotherapy in renal cell cancer

  • Themenschwerpunkt: Aktuelles in der Therapie Urologischer Tumoren
  • Published:
Acta Chirurgica Austriaca Aims and scope Submit manuscript

Zusammenfassung

Biologische Substanzen, wie Interferone (IFN), IL-2 und Tumornekrosefaktor (TNF-alpha), kommen in der Behandlung von Patienten mit metastasiertem Nierenzellkarzinom gegenwärtig nur innerhalb von prospektiven Studien in Frage, da für keine dieser Stoffe allgemein akzeptierte Therapieprotokolle existieren. In Deutschland ist zudem zu beachten, daß bisher nur das Interleukin-2 vom Bundesgesundheitsamt in Berlin zur Behandlung des Nierenzellkarzinoms zugelassen ist. Von den verschiedenen IFN erscheint IFN-alpha beim Nierenzellkarzinom die geeignetste Substanz zu sein. Bei Gabe von IFN-alpha sind jedoch nur in etwa 15% der Fälle objektive Remissionen zu erwarten wobei die Rate an kompletten Remissionen nur etwa 2% beträgt. Eine Monotherapie mit Interleukin-2 bringt keine signifikant besseren Behandlungsergebnisse als mit Interferon-alpha (IFN-alpha), geht jedoch mit höheren Nebenwirkungen einher. Bei der Kombination von IL-2 mit IFN-alpha lassen sich höhere Remissionsraten als bei der Monotherapie erzielen, wobei jedoch auch hier komplette Remissionen mit etwa 6% sehr selten sind. Der Tumornekrosefaktor befindet sich beim Nierenzellkarzinom noch in einem frühen Stadium der Erprobung.

Summary

At present, biological substances such as interferones (IFN), IL-2 and tumor necrosis factor (TNF-alpha) should be used in the treatment of patients with metastasized renal cell carcinoma only in the course of prospective trials, as there are no generally accepted therapy protocols for any of these substances. In Germany, moreover, it is important to note that only Interleukin-2 has as yet been approved for the treatment of renal cell carcinoma by the Federal Department of Health in Berlin. Of the various interferones. IFN-alpha appears to be the most suitable substance for treatment of metastasized renal cell carcinoma. Nevertheless, after the administration of IFN-alpha, objective remission can be expected in only 15% of all cases, complete remission accounting for only 2% of the total. The results of monotherapy with Interleukin-2 are not significantly better than those with Interferon-alpha, although the former is accompanied by a higher incidence of side-effects. A combination of IL-2 with Interferon-alpha results in higher remission rates than in the case of monotherapy with either substance, although here too, complete remissions, which account for a more 6% of the total, are very rare. The tumor necrosis factor is still at an early stage of testing for renal cell carcinoma.

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  1. Urologischen Klinik und Poliklinik der Medizinischen Akademie Dresden, Josef-Schneider-Straße 2, Deutschland

    M. Wirth

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Wirth, M. Immuntherapie beim Nierenzellkarzinom. Acta Chir Austriaca 25, 32–34 (1993). https://doi.org/10.1007/BF02602027

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  • DOI: https://doi.org/10.1007/BF02602027

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