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Prostatakarzinom

Die Vakzinierung als neue Therapieoption

Prostate carcinoma

Vaccination as a new option for treatment

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Zusammenfassung

Die Immuntherapie und Tumorzellvakzinierung ist eine herausfordernde Therapieoption beim Prostatakrebs, zumal Nebenwirkungen nur selten auftreten. In diesem Review werden aktuelle Entwicklungen in der Vakzinierungstherapie des Prostatakarzinoms diskutiert. Die FDA-genehmigte antigenpräsentierende Zellvakzine Sipuleucel-T wird im Detail beschrieben, ebenso wie neue Strategien in der Immuntherapie wie die der RNA und Peptidvakzinierung. Derzeit ist der Erfolg einer Prostatakrebsvakzinierung immer noch mit Einschränkungen verbunden. Die immunsuppressive Wirkung des Tumors im lokalen Mikroenvironment und die Ausbildung regulatorischer T-Zellen, die das Immunsystem in seiner Effektorfunktion unterdrücken, limitieren den Therapieerfolg. Das Konzept der immunologischen „Schnittstellen-Checkpointmodulation“ beschreibt die gezielte Beeinflussung immunologischer Schnittstellen, um Toleranzmechanismen zu durchbrechen und die Immunantwort zu steigern. Mögliche klinische Mechanismen einer Checkpointmodulation werden skizziert.

Abstract

Immune therapy and tumor cell vaccination is a challenging option in prostate cancer therapy, especially as side effects rarely occur. This review highlights recent developments in vaccination therapy of prostate cancer. The FDA approved antigen presenting cell vaccine Sipuleucel-T is described and new strategies of immune therapy like RNA and peptide vaccination are discussed in detail. Currently the effect of prostate cancer vaccination has still limitations, at least partially due to the immune suppressive effects of the tumor microenvironment and regulatory T cells, which suppress the immune effector function. To overcome these hurdles the concept of immune checkpoint modulation, which has the aim to break tolerance mechanisms, is discussed. Potential clinical therapies of checkpoint modulation are outlined.

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Interessenskonflikt

Der korrespondierende Autor weißt auf folgende Beziehungen hin: Studienteilnahme, Referenten-/Beratertätigkeit für Curevac, Karl Storz, Bayer, GSK, Immatics, Novartis, Pfizer, Roche.

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Authors and Affiliations

  1. Klinik für Urologie, Eberhard Karls Universität Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland

    J. Bedke & A. Stenzl

  2. Abteilung für Immunologie, Eberhard Karls Universität Tübingen, Tübingen, Deutschland

    C. Gouttefangeas

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  1. J. Bedke
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  2. C. Gouttefangeas
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  3. A. Stenzl
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Correspondence to J. Bedke.

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Bedke, J., Gouttefangeas, C. & Stenzl, A. Prostatakarzinom. Urologe 51, 44–49 (2012). https://doi.org/10.1007/s00120-011-2712-6

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  • DOI: https://doi.org/10.1007/s00120-011-2712-6

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