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Tumorimpfstoffe

Cancer vaccines

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best practice onkologie Aims and scope

Zusammenfassung

Hintergrund

Krebsimpfstoffe können das patienteneigene Immunsystem gezielt gegen Tumorzellen richten, indem sie Anti-Tumor-Immunantworten induzieren oder verstärken.

Ziel der Arbeit

Ziel der Arbeit ist es, einen Überblick über die sich rasch entwickelnde therapeutische Tumorvakzinierung, immunologische Hintergründe, Arten von Zielantigenen und Applikationsformen sowie deren Einsatz in der Behandlung maligner Erkrankungen zu geben.

Material und Methoden

Es erfolgte eine selektive Literaturrecherche.

Ergebnisse

Tumorvakzine vermögen potente T‑Zell-Immunantworten gegen Tumorantigene zu induzieren. Hierzu gehören tumorassoziierte Selbstantigene, Neoantigene aus tumorspezifischen Mutationen oder onkovirale Antigene. Verschiedenste Applikationsformen wie dendritische Zellvakzine, Peptid- oder auch RNA-Vakzine stehen zur Verfügung und werden in aktuellen klinischen Studien untersucht. Für den klinischen Erfolg einer Tumorimpfung ist neben der Auswahl geeigneter Zielantigene ein optimales Verhältnis von tumorantigenspezifischen T‑Zellen zu zielantigenpräsentierenden Tumorzellen unabdingbar, welches insbesondere in der adjuvanten Therapiesituation gegeben ist. Kombinationstherapien, insbesondere mit Immuncheckpointinhibitoren, versprechen hierbei synergistische Effekte, um den therapeutischen Nutzen von Tumorvakzinierungen weiter zu steigern.

Schlussfolgerung

Zunehmend auch in der Breite anwendbare Methoden der Personalisierung ermöglichen die Anwendung individualisierter therapeutischer Krebsimpfstoffe auch in größeren Patientenkollektiven. Die Auswahl der Zielantigene ist von zentraler Bedeutung für die Wirksamkeit der Tumorimpfstoffe, da deren Immunogenität und tumorspezifische Präsentation über HLA-Moleküle grundlegend für die Induktion tumorreaktiver T‑Zellen ist.

Abstract

Background

Cancer vaccines can specifically target the patient’s immune system against tumor cells by inducing or enhancing antitumor immune responses.

Objectives

The aim of this article is to provide an overview of immunological backgrounds, target antigens, cancer vaccine formats and their respective use in the treatment of cancer.

Materials and methods

A selective literature search was performed.

Results

Cancer vaccines are able to induce potent T cell responses against tumor antigens. These include tumor-associated self-antigens, neoantigens derived from tumor-specific mutations, or oncoviral antigens. Various vaccine formats including dendritic cell vaccines, peptide or RNA-based vaccines are available and are under investigation in current clinical trials. In addition to the selection of suitable target antigens, an optimal ratio of tumor antigen-specific T cells to tumor cells is essential for the clinical success of cancer vaccines and is often given in the adjuvant treatment setting. Furthermore, combination therapies, especially with immune checkpoint inhibitors, promise synergistic effects to further improve the effectiveness of tumor vaccination.

Conclusion

The increasing number of methods available for personalization enable the use of individualized cancer vaccine approaches in larger patient populations. The selection of target antigens is essential for the efficacy of cancer vaccines because their immunogenicity and tumor-specific presentation via HLA (human leukocyte antigen) molecules is fundamental for the induction of tumor-reactive T cells.

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Author information

Authors and Affiliations

  1. Department of Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tübingen, Tübingen, Deutschland

    Malte Roerden

  2. Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Deutschland

    Malte Roerden &  Juliane S. Walz

  3. Cluster of Excellence iFIT (EXC2180) „Image-Guided and Functionally Instructed Tumor Therapies“, University of Tübingen, Tübingen, Deutschland

    Malte Roerden &  Juliane S. Walz

  4. Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Straße 10, 72076, Tübingen, Deutschland

    Juliane S. Walz

  5. German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), partner site Tübingen, Tübingen, Deutschland

    Juliane S. Walz

  6. Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology and Robert Bosch Center for Tumor Diseases (RBCT), Stuttgart, Deutschland

    Juliane S. Walz

Authors
  1. Malte Roerden
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Correspondence to Juliane S. Walz.

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Interessenkonflikt

M. Roerden und J.S. Walz geben an, dass kein Interessenkonflikt besteht.

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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Stephan Schmitz, Köln

Dieser Beitrag erschien zuerst in Der Onkologe 2021 · 27:1101–1108. https://doi.org/10.1007/s00761-021-01012-8

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Roerden, M., Walz, J.S. Tumorimpfstoffe. best practice onkologie 16, 572–580 (2021). https://doi.org/10.1007/s11654-021-00356-2

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