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Erschienen in: best practice onkologie 11/2021

22.10.2021 | Topic

Immuntherapie bei Kopf-Hals-Plattenepithelkarzinomen

Abskopale Effekte in Kombination mit Radiotherapie, außergewöhnliche Reaktionen in Kombination mit Chemotherapie und Pseudoprogression

verfasst von: N. Brix, L. Dunn, T. Seiwert, C. Belka, K. Lauber

Erschienen in: best practice onkologie | Ausgabe 11/2021

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Zusammenfassung

Hintergrund

Das Therapieportfolio für rekurrente und/oder metastasierte Kopf-Hals-Plattenepithelkarzinome („Head and neck squamous cell carcinoma“ [HNSCC]) hat sich mit der klinischen Implementierung der Immuntherapie erweitert: Die einzige molekular zielgerichtete Therapieoption bis zum Jahr 2016 war die Epidermal-growth-factor-receptor(EGFR)-Blockade. Inzwischen ist jedoch die Immuncheckpointinhibition Teil der Erstlinientherapie beim rekurrenten oder metastasierten HNSCC.

Fragestellung

Untersucht wurde, inwieweit bei der Immuntherapie des HNSCC abskopale Effekte der Strahlentherapie, ausgeprägte Synergien mit Chemotherapie sowie Pseudoprogressionsphänomene auftreten.

Material und Methoden

Literaturrecherche unter Berücksichtigung aktueller klinischer Studien zur Immuntherapie von HNSCC wie auch präklinischer Arbeiten über die zugrunde liegenden biologischen Mechanismen.

Ergebnisse

Wie bei anderen Tumorentitäten bereits beobachtet, treten auch bei der Therapie des rekurrenten und/oder metastasierten HNSCC synergistische Effekte bei Kombination der Immuntherapie mit Radio- und/oder Chemotherapie in der Klinik auf. Ursächlich hierfür ist eine (Re‑)Aktivierung der körpereigenen Antitumorimmunantwort. In Einzelfällen tritt dies in der Bildgebung in Form einer Pseudoprogression in Erscheinung. Verlässliche Biomarker für die genannten Phänomene sind klinisch bisher nicht etabliert.

Schlussfolgerungen

Auch beim rekurrenten und/oder metastasierten HNSCC werden sich systemische Effekte der Radiochemoimmuntherapie in der Klinik mehren. Entsprechend wird die Suche nach Biomarkern für abskopale Effekte der Strahlentherapie und unerwartet starke Synergien mit Chemotherapeutika unter Immuntherapie sowie für Pseudoprogression an Bedeutung gewinnen.
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Metadaten
Titel
Immuntherapie bei Kopf-Hals-Plattenepithelkarzinomen
Abskopale Effekte in Kombination mit Radiotherapie, außergewöhnliche Reaktionen in Kombination mit Chemotherapie und Pseudoprogression
verfasst von
N. Brix
L. Dunn
T. Seiwert
C. Belka
K. Lauber
Publikationsdatum
22.10.2021
Verlag
Springer Medizin
Erschienen in
best practice onkologie / Ausgabe 11/2021
Print ISSN: 0946-4565
Elektronische ISSN: 1862-8559
DOI
https://doi.org/10.1007/s11654-021-00347-3

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