Neue Therapien in der Onkologie – Wirkweise und Nebenwirkungen

Jens Panse

doi:10.1055/a-1166-4330

Zeitschrift für Palliativmedizin, Table of Contents

Zeitschrift für Palliativmedizin 2020; 21(06): 317-333
DOI: 10.1055/a-1166-4330

CME-Weiterbildung

Neue Therapien in der Onkologie – Wirkweise und Nebenwirkungen

Jens Panse

Subject Editor: Wissenschaftlich verantwortlich gemäß Zertifizierungsbestimmungen für diesen Beitrag ist Dr. med. Jens Panse, Aachen.

Abstract

Während klassische Chemotherapeutika als Angriffspunkte primär tumoreigenes Wachstum hemmen und Apoptosestimulation nutzen, wirken neuere Therapiestrategien über eine möglichst zielgerichtete Unterbindung einzelner tumorspezifischer Eigenschaften. Dieser Übersichtsartikel soll grundlegende aktuelle Konzepte verständlich machen und auf teilweise spezielle Nebenwirkungen neuerer Therapieformen hinweisen.

Schlüsselwörter

zielgerichtete Therapie - Onkologie - personalisierte Medizin - Immuntherapie - CAR-T-Zelltherapie

Full Text

References

Literatur
1 DeVita Jr VT, Chu E. A history of cancer chemotherapy. Cancer Res 2008; 68: 8643-8653
2 Rosas D, Raez LE. Review of the agnostic-type treatment approach: treating cancer by mutations, not by location. Oncol Ther 2020; 8: 59-66
3 Wirk B, Wingard JR, Moreb JS. Extramedullary disease in plasma cell myeloma: the iceberg phenomenon. Bone Marrow Transplant 2013; 48: 10-18
4 Alt-Epping B, Fuxius S, Wedding U. Hrsg. Onkologie für die Palliativmedizin. 2015.
5 Hanahan D, Weinberg RA. The hallmarks of cancer. Cell 2000; 100: 57-70
6 Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell 2011; 144: 646-674
7 Baudino TA. Targeted cancer therapy: the next generation of cancer treatment. Curr Drug Discov Technol 2015; 12: 3-20
8 Zhang J, Yang PL, Gray NS. Targeting cancer with small molecule kinase inhibitors. Nat Rev Cancer 2009; 9: 28-39
9 Kämmerer W. Interaktionen Achtung bei Tyrosinkinase-Inhibitoren. Pharmazeut Z; 2009 20.
10 Müller-Tidow CK, Brunnberg U, Berdel U. et al. Tyrosinkinasen als Ziele neuer onkologischer Therapien. Dtsch Ärztebl 2007; 104: A-1312-1319
11 Reungwetwattana T, Nakagawa K, Cho BC. et al. CNS Response to osimertinib versus standard epidermal growth factor receptor tyrosine kinase inhibitors in patients with untreated egfr-mutated advanced non-small-cell lung cancer. J Clin Oncol 2018; 36: 3290-3297
12 Valiente M, Ahluwalia MS, Boire A. et al. The Evolving landscape of brain metastasis. Trends Cancer 2018; 4: 176-196
13 Hurvitz SA, OʼShaughnessy J, Mason G. et al. Central Nervous system metastasis in patients with her2-positive metastatic breast cancer: patient characteristics, treatment, and survival from SystHERs. Cancer Res 2019; 25: 2433-2441
14 Piper-Vallillo AJ, Sequist LV, Piotrowska Z. Emerging Treatment paradigms for egfr-mutant lung cancers progressing on osimertinib: a review. J Clin Oncol 2020;
15 Ramalingam SS, Vansteenkiste J, Planchard D. et al. Overall Survival with osimertinib in untreated, EGFR-mutated advanced NSCLC. N Engl J Med 2020; 382: 41-50
16 Camidge DR, Pao W, Sequist LV. Acquired resistance to TKIs in solid tumours: learning from lung cancer. Nat Rev Clin Oncol 2014; 11: 473-481
17 Park K, Yu CJ, Kim SW. et al. First-Line erlotinib therapy until and beyond response evaluation criteria in solid tumors progression in asian patients with epidermal growth factor receptor mutation-positive non-small-cell lung cancer: the ASPIRATION Study. JAMA Oncol 2016; 2: 305-312
18 Vavala T, Follador A, Tiseo M. et al. BE-POSITIVE: Beyond progression after tyrosine kinase inhibitor in EGFR- positive non small cell lung cancer patients: Results from a multicenter Italian observational study. Lung Cancer 2016; 95: 73-81
19 Weickhardt AJ, Scheier B, Burke JM. et al. Local ablative therapy of oligoprogressive disease prolongs disease control by tyrosine kinase inhibitors in oncogene-addicted non-small-cell lung cancer. J Thorac Oncol 2012; 7: 1807-1814
20 Alt-Epping B. Was soll die Palliativmedizin im Tumorboard?. Forum 2019; 34: 331-334
21 Kolb G, Bokemeyer C, Wedding U. Geriatrisches Assessment: Integration ins Tumorboard. Dtsch Ärztebl 2020; 117: A-1382/B-1182
22 Lacouture M, Sibaud V. Toxic side effects of targeted therapies and immunotherapies affecting the skin, oral mucosa, hair, and nails. Am J Clin Dermatol 2018; 19: 31-39
23 Tsimberidou AM, Kurzrock R. Precision medicine: lessons learned from the SHIVA trial. Lancet Oncol 2015; 16: e579-580
24 Sicklick JK, Kato S, Okamura R. et al. Molecular profiling of cancer patients enables personalized combination therapy: the I-PREDICT study. Nat Med 2019; 25: 744-750
25 Nagarkar R, Patil D, Crook T. et al. Encyclopedic tumor analysis for guiding treatment of advanced, broadly refractory cancers: results from the RESILIENT trial. Oncotarget 2019; 10: 5605-5621
26 Teleanu RI, Chircov C, Grumezescu AM. et al. Tumor Angiogenesis and anti-angiogenic strategies for cancer treatment. J Clin Med 2019; 9: 84
27 Sharma P, Allison JP. The future of immune checkpoint therapy. Science 2015; 348: 56-61
28 Rotte A. Combination of CTLA-4 and PD-1 blockers for treatment of cancer. J Exp Clin Cancer Res 2019; 38: 255
29 Hause RJ, Pritchard CC, Shendure J. et al. Classification and characterization of microsatellite instability across 18 cancer types. Nat Med 2016; 22: 1342-1350
30 Luchini C, Bibeau F, Ligtenberg MJL. et al. ESMO recommendations on microsatellite instability testing for immunotherapy in cancer, and its relationship with PD-1/PD-L1 expression and tumour mutational burden: a systematic review-based approach. Annals of oncology: official journal of the European Society for Medical Oncology / ESMO 2019; 30: 1232-1243
31 Miller AM, DeAngelis LM. Reevaluation of the Frequent Use of PD-1 Checkpoint Inhibitors for Treatment of Glioblastoma. JAMA 2020; 323: 2482-2484
32 Bedognetti D, Ceccarelli M, Galluzzi L. et al. Toward a comprehensive view of cancer immune responsiveness: a synopsis from the SITC workshop. J Immunother Cancer 2019; 7: 131
33 Heinzerling L, de Toni E, Schett G. et al. Checkpoint-Inhibitoren Diagnostik und Therapie von Nebenwirkungen. Dtsch Ärztebl 2019; 116: 119-126
34 Chai LF, Prince E, Pillarisetty VG. et al. Challenges in assessing solid tumor responses to immunotherapy. Cancer Gene Ther 2020; 27: 528-538
35 Toi Y, Sugawara S, Kawashima Y. et al. Association of immune-related adverse events with clinical benefit in patients with advanced non-small-cell lung cancer Treated with Nivolumab. Oncologist 2018; 23: 1358-1365
36 Haen SP, Loffler MW, Rammensee HG. et al. Towards new horizons: characterization, classification and implications of the tumour antigenic repertoire. Nat Rev Clin Oncol 2020;
37 Rosenbaum L. Tragedy, perseverance, and chance – the story of CAR-T therapy. N Engl J Med 2017; 377: 1313-1315
38 Urba WJ, Longo DL. Redirecting T cells. N Engl J Med 2011; 365: 754-757
39 Buchholz CJ, Hartmann J, Schüßler-Lenz M. et al. CAR-T-Zell-Therapie: Aussichten und Risiken. Dtsch Ärztebl 2018; 115: 38-41
40 Mukherjee S. The Promise and price of cellular therapies. The New Yorker; 2019. https://www.newyorker.com/magazine/2019/07/22/the-promise-and-price-of-cellular-therapies
41 Repp R, Valerius T, Bargou R. Bispezifische Antikörper in der Hämatologie und Onkologie. Der Internist 2001; 42: 854-859
42 Przespolewski AC, Griffiths EA. BITES and CARS and checkpoints, oh my! Updates regarding immunotherapy for myeloid malignancies from the 2018 annual ASH meeting. Blood reviews 2020;
43 Le Saux O, Falandry C, Gan HK. et al. Inclusion of elderly patients in oncology clinical trials. Ann Oncol 2016; 27: 1799-1804