CC BY-NC-ND 4.0 · Laryngorhinootologie 2018; 97(S 01): S48-S113
DOI: 10.1055/s-0043-121596
Referat
Eigentümer und Copyright ©Georg Thieme Verlag KG 2018

HPV – Das andere Kopf-Hals-Karzinom

Artikel in mehreren Sprachen: deutsch | English
Claus Wittekindt
1   Klinik für HNO-Heilkunde, Kopf-/Halschirurgie, Plastische Operationen, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
,
Steffen Wagner
1   Klinik für HNO-Heilkunde, Kopf-/Halschirurgie, Plastische Operationen, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
,
Shachi Jenny Sharma
1   Klinik für HNO-Heilkunde, Kopf-/Halschirurgie, Plastische Operationen, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
,
Nora Würdemann
1   Klinik für HNO-Heilkunde, Kopf-/Halschirurgie, Plastische Operationen, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
,
Jennifer Knuth
1   Klinik für HNO-Heilkunde, Kopf-/Halschirurgie, Plastische Operationen, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
,
Henrike Reder
1   Klinik für HNO-Heilkunde, Kopf-/Halschirurgie, Plastische Operationen, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
,
Jens Peter Klußmann
1   Klinik für HNO-Heilkunde, Kopf-/Halschirurgie, Plastische Operationen, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
22. März 2018 (online)

Zusammenfassung

Kopf-Hals-Tumore sind die sechst-häufigste Krebsart mit über 500000 jährlich gemeldeten Fällen weltweit. Die Hauptrisikofaktoren sind Tabak- und Alkoholkonsum, wobei v. a. Oropharynxkarzinome (OSCC) vermehrt eine Assoziation mit humanen Papillomaviren (HPV) aufweisen. Bei HPV-assoziierten und HPV-negativen OSCC handelt es sich bezüglich biologischer Charakteristika, Therapieansprechen und Prognose der Patienten um 2 eigenständige Entitäten, die allerdings bisher identisch behandelt werden. Bei HPV OSCC spielen neben der Aktivität viraler Onkoproteine auch genetische (Mutationen und chromosomale Aberrationen) und epigenetische Veränderungen eine entscheidende Rolle bei der Krebsentstehung. Aufgrund des besseren Therapieansprechens wird aktuell über die Einführung einer De-Intensivierung der Therapie und über zielgerichtete Therapieoptionen für Patienten mit HPV OSCC diskutiert. Ein vielversprechendes zielgerichtetes Therapiekonzept ist bspw. die Immuntherapie. Besonders intensiv wird derzeit die Anwendung von Checkpoint-Inhibitoren (z. B. gegen PD1) erforscht. Mithilfe sogenannter Flüssigbiopsien sollen zukünftig weitere Biomarker, in Form von viraler DNA oder Tumor-Mutationen, zur Überwachung des Krankheitsverlaufs und frühzeitigen Erkennens von Therapieversagen eingesetzt werden. Zur primären Prophylaxe einer Tumorentstehung ist die HPV-Impfung von männlichen und weiblichen Jugendlichen empfehlenswert.

 
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