Zusammenfassung
Bis vor ca. 10 Jahren standen dem Arzt zur Behandlung von Tumoren nur Chirurgie, Bestrahlung und Chemotherapie zur Verfügung. Als vierte Option etabliert sich mehr und mehr die „Immuntherapie“, die gegenwärtig zum großen Teil auf der Anwendung von Biologischen Response Modifiern beruht. Die IFNe-α stellen die als erste „Biological Response Modifiers“ dar, die klinisch ausgetestet wurden. Für viele Tumorindikationen ist der Stellenwert der IFN-Monotherapie bereits erarbeitet und etabliert (s. Kapitel „Die Monotherapie mit Interferonen bei soliden Tumoren und hämatologischen Erkrankungen“). Hingegen hat die klinische Austestung von IFN und Zytostatikakombinationen erst begonnen. Wichtig und notwendig bei der Entwicklung von IFN-Zytostatika-Kombinationen sind Erkenntnisse über die Wirkungsweise von IFNen, Zytostatika und deren Kombinationen, die bis heute jedoch erst sehr rudimentär vorliegen. Besonders problematisch für die Erarbeitung einer neuen IFN-Zytostatika-Kombination ist die Unkenntnis darüber, welcher der zahlreichen bekannten in vitro Wirkungsmechanismen für die in vivo beobachtete antitumorale Aktivität der IFNe verantwortlich ist. Denn IFNe wirken sowohl direkt auf Tumorzellen, in dem sie das Wachstum hemmen, Zellmembranen verändern und intrazelluläre Proteine in den Tumorzellen induzieren [1]. IFNe wirken aber auch auf den Gesamtorganismus, in dem sie verschiedene Immuneffektorzellen wie Monozyten oder Lymphozyten aktivieren. Durch diese Aktivierung können die IFNe auch indirekt antitumoral wirken [2]. Eine Reihe von hypothetischen Mechanismen könnte eine Kombination von IFN und Zytostatika sinnvoll erscheinen lassen.
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Bonnem, E., von Wussow, P. (1990). Therapiemodalitäten. In: Niederle, N., von Wussow, P. (eds) Interferone. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-93383-7_23
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