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Systemische Immuncheckpoint-Inhibition

Eine vielversprechende Therapie urologischer Tumoren?

Systemic immune checkpoint inhibition

A promising treatment for urological tumors?

  • Molekulare Urologie praxisnah
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Zusammenfassung

Das bessere Verständnis der immunmodulierenden Interaktionen zwischen Tumorzelle und Immunzellen führten zu neuen vielversprechenden systemischen Therapieansätzen in der Erst- und Zweitlinientherapie urologischer Tumoren. Besonders beim Urothelkarzinom steht seit 20 Jahren erstmals mit den Checkpointinhibitoren (PD-1- und PDL-1-Inhibitoren) eine gut verträgliche Therapie zur Verfügung, die Ansprechraten >20 % erzielt, die dauerhaft anhalten können. Diese Übersichtsarbeit erklärt den Ansatz der Immuntherapie und fasst die aktuelle Phase-III-Studienlage zum Urothelkarzinom und Nierenzellkarzinom zusammen. Die aktuellen immunmodulatorischen Therapieansätze werden beim Prostatakarzinom diskutiert. Abschließend beleuchten wir neue immunmodulatorische Therapieformen in der Grundlagenforschung.

Abstract

Improved understanding of the immunomodulatory interactions between tumor cells and immune cells has led to new and promising systemic therapeutic approaches in the first- and second-line therapy of urological tumors. Particularly in the case of urothelial carcinoma, for the first time in 20 years, checkpoint inhibitors (PD-1 and PDL-1 inhibitors) provide well-tolerated therapy that achieves response rates of >20% that can be sustained over the long term. This review explains the approach of immunotherapy and summarizes the current phase III clinical situation on urothelial carcinoma and renal cell carcinoma. The current immunomodulatory therapeutic approaches for prostate cancer are discussed. Finally, we highlight new immunomodulatory therapeutic approaches in basic research.

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Authors and Affiliations

  1. Klinik für Urologie des Universitätsklinikums, Johann Wolfgang Goethe Universität Frankfurt, Frankfurt, Deutschland

    F. C. Roos

  2. Forschungskoordination, Deutsche Gesellschaft für Urologie (DGU) e. V., Uerdinger Straße 64, 40474, Düsseldorf, Deutschland

    C. Becker

  3. Klinik und Poliklinik für Urologie, Universitätsmedizin Greifswald, Greifswald, Deutschland

    M. B. Stope

  4. Klinik für Urologie und Kinderurologie, Universitätsmedizin Mainz, Mainz, Deutschland

    I. Tsaur

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Fachgruppe Molekulare Urologie der Arbeitsgruppe urologische Forschung (AuF) der Deutschen Gesellschaft für Urologie

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Correspondence to C. Becker.

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F. C. Roos, C. Becker, M. B. Stope und I. Tsaur geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Roos, F.C., Becker, C., Stope, M.B. et al. Systemische Immuncheckpoint-Inhibition. Urologe 57, 583–590 (2018). https://doi.org/10.1007/s00120-018-0622-6

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