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Molekulare Tumortherapie

Antikörper und kleine Moleküle

Molecular tumour therapy

Antibodies and small molecules

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Zusammenfassung

Molekulare Tumortherapie stellt einen der wesentlichen Fortschritte in der Behandlung maligner Erkrankungen dar. Die Erwartung an diese Behandlungsmöglichkeiten ist ein möglichst spezifischer Angriff auf die malignen Zellen und die intrazellulär deregulierten Signaltransduktionswege. Hierdurch soll eine höhere Tumorwirksamkeit möglichst unter Vermeidung von Begleittoxizitäten erreicht werden. Zwei wesentliche Instrumente, die heute für die molekulare Tumortherapie zur Verfügung stehen, sind die an der Zelloberfläche angreifenden monoklonalen Antikörper sowie die intrazellulär wirksamen kleinen Moleküle insbesondere Tyrosinkinaseinhibitoren. Beide Therapieprinzipien haben spezifische Vorteile, aber auch Limitationen. Beide Substanzklassen werden neben bestimmten Leukämien auch bei Lymphomen und zunehmend auch bei soliden Tumoren eingesetzt. Bei einigen Tumorentitäten haben sie deren Prognose teilweise dramatisch verbessert. Neu bei dieser Art von Therapie ist also, dass die Therapie gesteuert wird durch Präsenz eines definierten Markers auf der Tumorzelle.

Abstract

Molecular tumor therapy based on understanding the principles of malignant transformation has resulted in a dramatic progress in cancer therapy. Targeted therapies attack the malignant cells and, more specifically, the deregulated intracellular signal transduction. Therefore a high efficacy with lower side effects then classical chemotherapy is expected.

There are two different drug classes available: monoclonal antibodies targeting surface molecules, as well as intracellular acting small molecules, especially tyrosine kinase inhibitors. Both modalities have specific advances but also limitations, and have resulted in greater life expectancy in certain solid and hematopoietic tumors such as certain leukemias, lymphoma, breast and lung cancers. The limiting factors are i) the drug can only be applied when the targeted protein is expressed; ii) the high cost associated with these therapies.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: Reisekostenerstattung durch die Firma Roche Pharma AG.

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  1. Klinik für Innere Medizin SP Hämatologie, Onkologie, Immunologie, Universitätsklinikum Gießen und Marburg, Standort Marburg, Baldingerstraße 1, 35033, Marburg, Deutschland

    C. Wilhelm & A. Neubauer

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Correspondence to C. Wilhelm.

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Wilhelm, C., Neubauer, A. Molekulare Tumortherapie. Internist 49, 581–592 (2008). https://doi.org/10.1007/s00108-008-2096-x

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