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Therapie der indolenten Non-Hodgkin-Lymphome

Therapy of indolent non-Hodgkin lymphoma

  • CME Zertifizierte Fortbildung
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Der Onkologe Aims and scope

Zusammenfassung

Ziel

Dieser Artikel gibt einen Überblick über aktuelle Therapiestrategien bei indolenten Lymphomen.

Inhalte

Antikörperbasierte Therapieschemata sind bei vielen hämatologischen und onkologischen Erkrankungen als Therapiestandards etabliert und revolutionierten v. a. die Behandlung maligner Lymphome. 1997 wurde mit Rituximab der erste Antikörper von der US-amerikanischen Zulassungsbehörde zur Krebstherapie zugelassen. Sein Zielmolekül ist CD20, ein v. a. auf B-Lymphozyten und somit auf den meisten von B-Zellen abstammenden Non-Hodgkin-Lymphomen exprimiertes Protein. Vielversprechende Weiterentwicklungen des Antikörpers stehen in teils fortgeschrittenen Stadien der klinischen Prüfung. Tyrosinkinaseinhibitoren des B-Zell-Rezeptor-Signalpfads und immunmodulatorisch wirksame Substanzen sind weitere neue Therapiestrategien.

Schlussfolgerungen/Empfehlungen

Die Anti-CD20-basierte Therapie ist Standard bei vielen indolenten Lymphomen. Zielgerichtete und molekulare Therapieoptionen werden möglicherweise eine chemotherapiefreie Behandlung der indolenten Lymphome ermöglichen.

Abstract

Aim

This article gives a review of current treatment strategies for indolent lymphoma.

Content

Antibody-based therapy regimens are a well-established and integral element in the therapy of many hematological malignancies and have revolutionized the therapeutic management of malignant lymphoma. Rituximab was the first therapeutic antibody licensed for cancer therapy by the U.S. Food and Drug Administration (FDA) in 1997. This antibody targets CD20, a molecule expressed on B lymphocytes and therefore proteins expressed on the majority of B lymphocytes originating from non-Hodgkin lymphoma. Promising new antibody constructs as well as tyrosine kinase inhibitors targeting the B cell receptor signaling pathway and immunomodulatory drugs are currently being studied in partly advanced stage clinical trials.

Conclusion/recommendations

For many indolent lymphomas CD20-based therapy is the standard of treatment. New antibodies and small molecules might again change the standard of treatment in lymphoma therapy and open the way to chemotherapy-free therapeutic regimens.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Seiler, K. Herfarth, W. Klapper und M. Dreyling geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Medizinische Klinik III, Klinikum Großhadern, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, München, Deutschland

    T. Seiler & M. Dreyling

  2. Klinik für RadioOnkologie und Strahlentherapie, Universitätsklinikums Heidelberg, Heidelberg, Deutschland

    K. Herfarth

  3. Sektion Hämatopathologie und Lymphknotenregister, Institut für Pathologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland

    W. Klapper

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  1. T. Seiler
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  2. K. Herfarth
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  3. W. Klapper
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  4. M. Dreyling
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Corresponding authors

Correspondence to T. Seiler or M. Dreyling.

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Seiler, T., Herfarth, K., Klapper, W. et al. Therapie der indolenten Non-Hodgkin-Lymphome. Onkologe 20, 1027–1038 (2014). https://doi.org/10.1007/s00761-014-2786-z

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  • DOI: https://doi.org/10.1007/s00761-014-2786-z

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