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Immunmodulatorische Therapieansätze beim Prostatakarzinom

Immunomodulatory treatment approaches for prostate cancer

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Zusammenfassung

Während der letzten 10 Jahre wurden verschiedene Ansätze zur Immuntherapie beim Prostatakarzinom untersucht. Dazu gehören unspezifische sowie spezifische immunstimulierende bzw. immunmodulierende Therapien. Bei der unspezifischen Immuntherapie des Prostatakarzinoms werden humorale und zelluläre Reaktionsmechanismen des Immunsystems antigenunspezifisch moduliert oder stimuliert. Ziel ist die Auslösung einer Entzündungsreaktion oder eines anderen bereits bestehenden Abwehrmechanismus zur Bekämpfung des Malignoms. Die Mediatoren und Effektorzellen dieser unspezifischen Immunantwort sind humorale Faktoren wie Zytokine, Komplement und Akutphaseproteine sowie zelluläre Komponenten des Immunsystems, wie Neutrophile, Makrophagen/Monozyten, Mastzellen und Natural-Killer-Zellen.

Im Gegensatz dazu ist es das Ziel der spezifischen Immuntherapie, zelluläre und humorale Immuneffektormechanismen zur zielgerichteten Erkennung und Zerstörung von Tumorzellen zu aktivieren. Die erfolgversprechendsten Ansätze der spezifischen Immuntherapie sind dabei Vakzinierungsstrategien mit Generierung einer antitumoralen T-Zell-Antwort und die Verabreichung von Antikörpern.

In Rahmen einer PubMed-basierten Literaturrecherche wurden Publikationen zur immunmodulatorischen Therapie des Prostatakarzinoms identifiziert. Der vorliegende Artikel fokussiert auf die zum Zeitpunkt der Publikation vorliegenden klinischen Studien zu immunmodulatorischen Therapieoptionen beim Prostatakarzinom und stellt deren bisherige Ergebnisse dar.

Abstract

During the last 10 years different strategies for immunotherapy of prostate cancer have been investigated. These included unspecific and specific strategies to modulate or stimulate the immune system. For unspecific immunotherapy of prostate cancer innate humoral or cellular immune mechanisms are being stimulated, which are not specific to malignant cells. The global stimulation of the innate immune system is supposed to augment the immune reaction to prostate cancer by initiating an inflammatory reaction or other existing immune mechanisms. The main mediators and effectors of the unspecific immune system include humoral factors such as cytokines, complement system, and acute phase proteins and cellular components such as neutrophils, macrophages/monocytes, mast cells, and natural killer cells.

In contrast, specific immunotherapy aims at adaptive immunity. This portion of the immune system can be amplified and thus specifically target tumor cells. Generation of a tumor-specific T cell reaction by vaccination or application of antibodies are the most promising approaches of specific immunotherapy.

In a PubMed-based search of the current literature, publications regarding immunotherapy of prostate cancer were identified. The present article focuses on publications presenting clinical studies which investigate immunomodulatory treatments of prostate cancer. The results of these publications are described and discussed.

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  1. Urologische Klinik, Universitätsklinikum, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    M.A. Reiter, J. Pfitzenmaier, M. Hohenfellner &  A. Haferkamp

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  1. M.A. Reiter
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  2. J. Pfitzenmaier
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  3. M. Hohenfellner
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  4. A. Haferkamp
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Correspondence to A. Haferkamp.

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Reiter, M., Pfitzenmaier, J., Hohenfellner, M. et al. Immunmodulatorische Therapieansätze beim Prostatakarzinom. Urologe 48, 755–763 (2009). https://doi.org/10.1007/s00120-009-1984-6

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