Vakzinetherapie des Prostatakarzinoms

Zusammenfassung

Die Vakzinetherapie des Prostatakarzinoms unter Studienbedingungen hat erst in den letzten Jahren an Bedeutung gewonnen. Die verschiedenen Vakzinetechniken sind sehr variabel und werden in erster Linie bei Patienten mit fortgeschrittenem Prostatakarzinom und nach Versagen einer antihormonellen Therapie eingesetzt. In der vorliegenden Übersichtsarbeit werden Vakzinetechniken mit Tumorzellen, mit dendritischen Zellen oder mit Pockenviren analysiert. Für diese Ansätze sind Studien der Phase-III geplant, begonnen oder sogar abgeschlossen. Viele Studien zeigen eine Effektivität im Hinblick auf die Endpunkte einer Immunantwort und/oder biochemischem und/oder klinischem Ansprechen. Kürzlich konnte sogar für eine Vakzine mit autologen dendritischen Zellen gezeigt werden, dass es gegenüber Plazebo zu einer statistisch signifikanten Lebensverlängerung bei Patienten mit einem hormonrefraktären Prostatakarzinom kommt. Das Nebenwirkungsprofil der Vakzinetherapie ist dabei als äußerst günstig zu bezeichnen. Derzeit befinden sich Studien in Planung, die sowohl auf eine Kombination mit anderen Substanzen als auch auf die Behandlung früherer Krankheitsstadien abzielen.

Abstract

Vaccine therapy of prostate cancer has been increasingly studied in trials over the past few years. The different vaccine techniques are quite variable and are predominantly used in patients with advanced hormone-refractory prostate cancer. In this review, vaccine techniques using tumor cells, dendritic cells or poxvirus are analyzed. For theses approaches phase-III trials are being planned, have been initiated or are already completed. Many trials demonstrate the efficacy with regard to endpoints such as stimulation of the immune system and/or biochemical response and/or clinical response. Recently, one vaccine approach using autologous dendritic cells demonstrated a statistically significant prolongation of overall survival compared to placebo in patients with hormone-refractory prostate cancer. Side effects of vaccination are generally mild. At present, there are trials are being planned or are already ongoing that combine vaccine with other treatment strategies or enroll patients with earlier disease stages.

Schlüsselwörter

Prostatakarzinom - Immuntherapie - Vakzine - Tumorzelle - dendritische Zelle - Virus - Antigen - Zytokin - Wachstumsfaktor.

Key words

Prostate cancer - immunotherapy - vaccine - tumor cell - dendritic cell - virus - antigen - cytokine - growth factor.

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