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Molekulare Prädiktoren in der Immunonkologie

Molecular predictors in immune oncology

  • Schwerpunkt: Immunpathologie
  • Published:
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Zusammenfassung

Die rasante Entwicklung immunonkologischer Behandlungskonzepte wird von einer ebenso dynamischen Entwicklung assoziierter Biomarkerkonzepte zur Auswahl von Patienten, die von einer derartigen Therapie profitieren/nicht profitieren, begleitet. Neben einfachen auf der Expression von Zielmolekülen fußenden Strategien kommen in diesem Kontext zunehmend auch komplexere molekulare Herangehensweisen zum Einsatz. Diese umfassen beispielsweise die entitätsinformierte Bestimmung molekularbiologisch definierter Subtypen (z. B. mikrosatelliteninstabile Neoplasien) sowie Immunzelleffektorsignaturen und die Messung der Tumormutationslast als schon recht diagnostiknahe Biomarkerstrategien. Zudem befinden sich zahlreiche weitere molekulare Prädiktionskonzepte in Entwicklung. Begleitet wird die Identifikation neuer Einzelmarker von kombinatorischen Ansätzen, die Therapiealgorithmen zunehmend auf der integralen gleichzeitigen Evaluation mehrerer immunonkologischer Biomarker aufbauen. Die entsprechenden Entwicklungen im Feld werden in diesem Artikel kursorisch beleuchtet.

Abstract

The current rapid development of novel therapeutic approaches in immune oncology (IO) and specifically in the field of immune checkpoint inhibition is accompanied by an equally dynamic development of novel biomarker approaches for the identification of responding/non-responding patients under IO treatment. In addition to the measurement of the expression of checkpoint ligands/receptors, complex molecular predictors are gaining increasing attention in certain IO treatment constellations. This includes the entity informed identification of molecularly defined biological tumor subtypes (e.g., microsatellite instable neoplasms), the measurement of tumor mutational load and immune cell effector signatures as relatively routine diagnostic compatible novel biomarker strategies. In addition, a multitude of even more complex molecular IO biomarker approaches is emerging. This development is accompanied by new patient selection strategies which are based on the simultaneous combinatorial evaluation of more than one parameter. This article provides a comprehensive overview on currently relevant aspects in the field of IO biomarkers.

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Danksagung

Der Autor dankt Renate Hartmann für die exzellente Bildadaptation und die Hilfe bei der Erstellung des Manuskripts.

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  1. Institut für Pathologie, Technische Universität München, Trogerstraße 18, 81675, München, Deutschland

    W. Weichert

  2. Partner Site Munich, Deutsches Konsortium für Translationale Krebsforschung (DKTK), München, Deutschland

    W. Weichert

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W. Roth, Mainz

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Weichert, W. Molekulare Prädiktoren in der Immunonkologie. Pathologe 39, 546–555 (2018). https://doi.org/10.1007/s00292-018-0508-9

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