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Pharmakologische Charakterisierung von Kopf-Hals-Tumoren in Ex-vivo-Tests

Pharmacological characterization of head and neck cancer in ex-vivo tests

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Zusammenfassung

Wüsste man vor Therapiebeginn, welche Erfolgsaussicht pharmakologische Therapien von Plattenepithelkarzinomen der Kopf-Hals-Region („head and neck squamous cell carcinoma“, HNSCC) hätten, könnte man das bestgeeignete Pharmakon oder die wirksamste Kombination aus dem ständig größer werdenden Spektrum verfügbarer Pharmaka auswählen. Bisher erfolgt die Auswahl bestenfalls nach Verfügbarkeit leitlinienkonformer Therapeutika und geprüfter Kombinationen gemäß publizierten klinischen Studiendaten und geprüfter allgemeiner Wirksamkeit bei HNSCC. Die je nach Lokalisation, Metastasierungsverhalten, TNM- und UICC-Status (Union Internationale Contre le Cancer) differente Biologie der HNSCC im Kontext von Allgemeinzustand und Risiken des Patienten hinsichtlich Lebensstil und beruflicher Exposition lassen sich derzeit nicht für eine individuellere Therapieentscheidung nutzen. Ein Ausweg kann die prätherapeutische Testung bioptisch gewonnener Proben ex vivo sein. Dieser Übersichtartikel stellt die in letzter Zeit erzielten Entwicklungen auf diesem Gebiet dar und diskutiert an Ex-vivo-Tests zu stellende Anforderungen für ihre Einbeziehung in die Therapieentscheidung.

Abstract

Precise knowledge about the chance of success of a given pharmacologic therapy of head and neck squamous cell carcinoma (HNSCC) before starting therapy would be very desirable to guide the selection of the most suitable or the most efficient combination out of the ever-growing spectrum of available pharmaceuticals. This selection has hitherto been made at best on the basis of the availability of guideline-conformant and approved combinations according to results of published clinical studies and approved general effectiveness in HNSCC. However, the inhomogeneous biology of HNSCC depending on localization, varying metastatic behavior, TNM and UICC stage in the context of the patient’s general condition and risk status according to lifestyle and occupational exposure make it impossible to accurately predict the success of pharmacological therapy regimens for the individual HNSCC based on today’s clinical and pathohistological diagnostics. A solution may lie in the testing of biopsy specimens ex vivo before starting therapy. The present review describes recent advances in ex-vivo tests and discusses the requirements for their inclusion in the decision-making process.

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  1. HNO-Forschungslabor,Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde/Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 21, 04103, Leipzig, Deutschland

    G. Wichmann & A. Dietz

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  1. G. Wichmann
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  2. A. Dietz
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Correspondence to G. Wichmann.

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Wichmann, G., Dietz, A. Pharmakologische Charakterisierung von Kopf-Hals-Tumoren in Ex-vivo-Tests. HNO 59, 866–873 (2011). https://doi.org/10.1007/s00106-011-2362-4

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  • DOI: https://doi.org/10.1007/s00106-011-2362-4

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