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DOI: 10.1055/s-0041-106138
Molekulare Konzepte der Immunmodulation zur Behandlung des metastasierten Nierenzellkarzinoms: Wo stehen wir?
Molecular Concepts of Immunomodulation for the Treatment of Metastatic Renal Cell Carcinomas: Where are We Now?Publikationsverlauf
Publikationsdatum:
21. Oktober 2015 (online)
![](https://www.thieme-connect.de/media/uro/201506/lookinside/thumbnails/1009_10-1055-s-0041-106138-1.jpg)
Zusammenfassung
Die Einführung molekularer zielgerichteter Substanzen hat einen Wandel in der Therapie des metastasierten Nierenzellkarzinoms (mNZK) eingeleitet. Die Prognose betroffener Patienten verbesserte sich dadurch signifikant. Dennoch bleibt die Behandlung des mNZK sehr anspruchsvoll, da die meisten Patienten einen Progress erleben müssen und Langzeitüberlebende immer noch eine Seltenheit darstellen. Dieses ist eine klare Grundlage für die weitere Suche nach verbesserten Therapieoptionen. In den letzten Jahren ist die Immuntherapie durch die Entwicklung neuer Substanzen und Therapieansätze mit der zielgerichteten Aktivierung und Modulation des Immunsystems wieder in den Interessensfokus gerückt. Eine bedeutende Entwicklung ist die Anwendung sogenannter Immuncheckpoint-Inhibitoren, durch die eine zielgerichtete (Re-) Aktivierung von T-Zellen erfolgt. Nachfolgend werden die derzeitigen Methoden zur Verbesserung der Standardtherapien mit den etablierten zielgerichteten Substanzen dargestellt und diese mit den neuen immun-onkologischen Ansätzen der Checkpoint-Modulation in einen aktuellen Zusammenhang für die Behandlung von Patienten mit einem mNZK diskutiert.
Abstract
The introduction of molecular targeted agents has started to transform the treatment of metastatic renal cell carcinoma (mRCC), leading to a significant improvement of the prognosis of patients affected by that disease. However, treatment of metastatic disease still remains challenging as almost all patients will experience tumour progression and long-term survivors are very rare. This clearly warrants a continued search for improved treatment options. In recent years, the development of new substances and treatment approaches involving the targeted activation and modulation of the immune system have moved immunotherapy back into the focus of interest. A major development is the use of checkpoint inhibitors, which enable a targeted (re)activation of T cells. The following article describes the current methods used to improve standard treatment with the established targeted substances and discusses them along with the new immunooncological approaches of checkpoint modulation in the context of the treatment of mRCC patients.
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