Immunologie und Immuncheckpoint-Inhibition des Ovarialkarzinoms – aktuelle Aspekte

Zusammenfassung

Immuntherapien wie die Immuncheckpoint-Blockade (ICB) gegen das PD-1/PD-L1-System haben in der letzten Dekade die Behandlung zahlreicher Entitäten revolutioniert. Das Ovarialkarzinom ist bislang von diesen Erfolgen weitestgehend ausgenommen. Mögliche Ursachen liegen in einer gegenüber anderen Tumorarten vergleichsweise niedrigen Mutationslast, einer unzureichenden Präsentation von (Neo-)Antigenen sowie einer erhöhten Infiltration mit immunsuppressiven Immunzellen wie regulatorischen T-Zellen oder tumorassoziierten Makrophagen. In den bisher durchgeführten klinischen Studien waren die Ansprechraten auf Inhibitoren des PD-1/PD-L1-Checkpoints dementsprechend auch enttäuschend niedrig, jedoch zeigen sich auch beim Ovarialkarzinom vereinzelte Langzeitremissionen. Es gilt nun, einerseits geeignete prädiktive Biomarker zu finden, andererseits Kombinationspartner für die ICB-Therapie zu identifizieren, welche die Immunogenität des Ovarialkarzinoms erhöhen bzw. immunsuppressive Resistenzmechanismen durchbrechen können. Der vorliegende Artikel gibt eine Übersicht über das Immunmilieu im Ovarialkarzinom, dessen Einfluss auf die Wirkung einer ICB und fasst die bislang vorliegenden klinischen Studiendaten zur ICB beim Ovarialkarzinom zusammen.

Schlüsselwörter

Ovarialkarzinom - Immuncheckpoint-Blockade - PD-L1 - tumorinfiltrierende Lymphozyten

Publication History

Received: 24 January 2021

Accepted after revision: 05 April 2021

Article published online:
06 July 2021

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