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Aktuelle immuntherapeutische Ansätze beim multiplen Myelom

  • Udo Holtick
  • Christof ScheidEmail author
Topic
  • 13 Downloads

Zusammenfassung

Antikörper gegen CD38 („cluster of differentiation 38“) und SLAM-F7 („signaling lymphocytic activation molecule F7“) sind für die Therapie des multiplen Myeloms zugelassen und stellen eine neue immunologische Behandlungsform dar. Eine zunehmende Zahl an Kombinationen mit diesen Antikörpern wurde erfolgreich klinisch getestet und hat zu neuen Zulassungen in den USA und Europa geführt. Zusätzlich wurden Antibody-Drug-Konjugate für das Myelom entwickelt, deren klinische Wirksamkeit aber bisher eher gering war. Das „B cell maturation antigen“ (BCMA) ist aktuell das vielversprechendste Zielmolekül auf Myelomzellen. Bispezifische Antikörper und „T-cell engager“ gegen BCMA koppeln Effektor-T-Zellen an die Myelomzellen und haben hohe Ansprechraten gezeigt. Ebenso haben CAR T(„chimeric antigen receptor T“)-Zellen gegen BCMA eine erstaunliche Wirksamkeit bei stark vorbehandelten und refraktären Myelompatienten gezeigt. Sowohl antikörperbasierte als auch zelluläre immunologische Therapieansätze stellen derzeit die beeindruckendsten Fortschritte in der Myelombehandlung dar. Diese Arbeit soll einen Überblick über die klinisch relevantesten Entwicklungen in diesem Bereich geben.

Schlüsselwörter

Antikörper Bispezifische Antikörper  T‑Lymphocytes Immunkonjugate CART 

Current immunotherapeutic approaches for multiple myeloma

Abstract

Antibodies against CD38 (cluster of differentiation 38) and SLAMF7 (signaling lymphocytic activation molecule F7) have been approved for the treatment of myeloma and represent a new immunological treatment modality. An increasing number of combination regimens with these antibodies have been successfully clinically tested leading to approval both in the USA and Europe. In addition, antibody-drug conjugates have been developed for myeloma; however, the clinical efficacy is so far limited. The B cell maturation antigen (BCMA) is currently the most promising target on myeloma cells. Bispecific antibodies and T‑cell engagers against BCMA couple effector T‑cells to myeloma cells and have shown high response rates. Similarly, chimeric antigen receptor T (CAR T) cells against BCMA have shown remarkable activity in heavily pretreated and refractory myeloma patients. Both antibody-based and cellular immunological treatment approaches currently represent the most remarkable advances in myeloma treatment and this review provides an overview of the most clinically relevant developments in this field.

Keywords

Antibody Antibodies, bispecific T‑lymphocytes Immunoconjugates CART 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

U. Holtick erhielt Honorare von Amgen, Bristof-Myers-Squibb, Celgene, Janssen. C. Scheid erhielt Honorare von Amgen, Bristol-Myers-Squibb, Celgene, Janssen, Glaxo Smith-Kline, Novartis.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Klinik I für Innere MedizinCentrum für Integrierte Onkologie Aachen Bonn Köln Düsseldorf, Universitätsklinik KölnKölnDeutschland

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