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01.06.2011 | Leitthema

Molekular zielgerichtete Tumortherapie durch Eingriffe in die zelluläre Signaltransduktion

verfasst von: Dr. O.M. Niemoeller, M. Li, K. Lauber, C. Belka

Erschienen in: Die Onkologie | Ausgabe 6/2011

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Zusammenfassung

Die Erkenntnisse der molekularen Onkologie im Hinblick auf die Mechanismen der Krebsentstehung und die Besonderheiten maligner Tumorzellen haben in der vergangenen Dekade zur Entwicklung einer Reihe neuer, zielgerichteter Ansätze zur Behandlung von Krebserkrankungen geführt. Diese adressieren gezielt Moleküle und Signalwege, die für das Überleben, die Proliferation und die Ausbreitung maligner Zellen essenziell sind. Zentrale Ansatzpunkte sind die Schlüsselmodulatoren des programmierten Zelltods, Wachstumsfaktorrezeptor-Signalkaskaden und die Regulatoren des Tumor-Mikromilieus. Während die Inhibition des epidermalen Wachstumsfaktorrezeptors in diesem Kontext heute bereits einen festen Therapiebestandteil für bestimmte Malignome darstellt, befinden sich Substanzen, die über Todesrezeptorsignalwege oder die Regulation von Mitgliedern der BCL-2-Proteinfamilie gezielt den programmierten Zelltod (Apoptose) auslösen, noch in der klinischen Erprobung. Im Hinblick auf die therapeutische Modulation des Tumor-Mikromilieus zählen die Inhibition des Blutgefäßwachstums im Tumor und die Hemmung der integrinvermittelten Anheftung maligner Zellen an ihre Umgebung sowie die Blockierung bestimmter Enzymaktivitäten (Matrixmetalloproteinasen), die essenziell für die Auswanderung von Tumorzellen in umliegende Gewebe sind, zu den primären Angriffspunkten.
Gemeinsam ist all diesen Ansätzen der Versuch, eine möglichst spezifische therapeutische Wirkung auf den Tumor zu erzielen und damit die Nebenwirkungen am gesunden Körpergewebe zu minimieren. Tatsächlich unterscheidet sich das Nebenwirkungsspektrum der molekular zielgerichteten Therapien von dem der klassischen onkologischen Verfahren wie Strahlentherapie und Chemotherapie fundamental. Allerdings fand sich für die Mehrzahl dieser Substanzen in der klinischen Prüfung leider nur eine geringe Wirksamkeit, wenn sie als Monotherapie eingesetzt werden. Daher müssen die Kombination dieser Agenzien mit bewährten onkologischen Verfahren und ihre Integration in die bereits bestehenden multimodalen Behandlungsschemata zukünftig im Rahmen klinischer Studien weitergeführt werden, um den tatsächlichen therapeutischen Mehrwert dieser Ansätze bewerten zu können.
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Metadaten
Titel
Molekular zielgerichtete Tumortherapie durch Eingriffe in die zelluläre Signaltransduktion
verfasst von
Dr. O.M. Niemoeller
M. Li
K. Lauber
C. Belka
Publikationsdatum
01.06.2011
Verlag
Springer-Verlag
Erschienen in
Die Onkologie / Ausgabe 6/2011
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-011-2030-z

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