Chimäre antigenspezifische T-Lymphozyten und natürliche Killerzellen für die Krebsimmuntherapie

Zusammenfassung

Mehr als 20 Jahre nach den ersten Versuchen, die gezeigt haben, dass T-Lymphozyten mittels Gentransfer eines chimären Antigenrezeptors (CAR) künstlich mit einer Spezifität gegen Tumorantigene ausgerüstet werden können, erzielt dieser Ansatz bahnbrechende therapeutische Erfolge bei Patienten mit B-Zell-Leukämien unter Verwendung von Anti-CD19-CAR-T-Zellen. Die langanhaltende klinische Remission in Patienten mit ansonsten überaus schlechter Prognose ist der 2. und 3. Generation chimärer Antigenrezeptoren geschuldet, die nun die für eine Expansion von T-Lymphozyten in vivo wichtige Kostimulation intrinsisch innerhalb des CAR vorhalten. Der große therapeutische Durchbruch in zuvor unheilbaren hämatologischen Erkrankungen hat zu einer Flut von neuen therapeutischen Ansätzen in einer Vielzahl von hämatologischen und soliden Tumoren geführt, bei denen diese neue Zelltherapie nun klinisch erprobt wird. Es bleibt abzuwarten, ob sich die guten klinischen Ergebnisse, die bei akuten lymphatischen Leukämien (B-ALL) erzielt wurden, auch auf andere hämatologische Erkrankungen und insbesondere auch auf solide Tumoren ausweiten lassen. Nichtsdestotrotz stehen für Patienten mit B-Zell-Leukämien, bei denen bisherige Standardtherapien – inklusive einer Stammzelltransplantation – versagt haben, heute neue Therapieoptionen zur Verfügung. Diese effizienten Therapieverfahren sollten möglichst zeitnah auch für Patienten in Deutschland zugängig gemacht werden. Die Einrichtungen für Transfusionsmedizin, Hämatologie und Onkologie sowie die nationalen und internationalen Aufsichtsbehörden sind gefragt, hier konstruktiv und mit Blick auf den klinischen Bedarf – jedoch ebenfalls die Sicherheit – der Patienten eine rasche Verfügbarkeit in Deutschland zu gewährleisten.

Key words

chimäre Antigenrezeptoren (CAR) - T-Zellen - natürliche Killerzellen - Onkoimmunologie - akute lymphatische Leukämien

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