Innovative Antikörper-Therapien bei malignen Lymphomen

Zusammenfassung

Non-Hodgkin-Lymphome (NHL) sind eine in ihrer Inzidenz stetig zunehmende Gruppe maligner lymphatischer Neoplasien, an denen insbesondere Ältere erkranken. Aufgrund dieser Altersverteilung ist es unerlässlich, neue und gut verträgliche Behandlungsoptionen - neben „konventionellen“ Therapien, wie der Standardchemo- oder Hochdosischemotherapie mit Stammzelltransplantation - zu prüfen. Als eine dieser neuen, zielgerichteten Therapien haben sich monoklonale Antikörper, wie der anti-CD20-Antikörper Rituximab, etabliert. Andere, wie der anti-CD52-Antikörper Alemtuzumab, stehen für die Behandlung der chronisch lymphatischen Leukämie (CLL) sowie von T-Zell-Lymphomen zur Verfügung und werden in klinischen Studien geprüft. Als Weiterentwicklung zielgerichteter Therapeutika werden kombinierte Radioimmuntherapien für den klinischen Einsatz verwendet. Erste Erfahrungen bei fortgeschrittenen, indolenten Lymphomen sind vielversprechend. Der Einsatz bei aggressiven Lymphomen und in der Primärtherapie wird weiter in Studien geprüft. Dieser Beitrag soll einen Überblick über den klinischen Einsatz und die bisherigen Studienergebnisse innovativer Immuntherapien geben, wobei insbesondere auf die Indikationsgebiete und praktische Anwendung im klinischen Alltag eingegangen wird.

Summary

Non-HodgkinŽs lymphoma (NHL) includes a group of malignant lymphoproliferative disorders, that particularly occur in the elderly and have an continuously increasing incidence. Because of the age distribution new treatment options with low toxicity and minor side effects - apart from „conventional“ therapies like standard or high dose chemotherapy - are needed. Within these novel therapeutic modalities the use of the monoclonal antibody rituximab has been widely established. Other monoclonal antibodies, such as the anti-CD52-antibody alemtuzumab, are available for the treatment of chronic lymphatic leukemia (CLL) and T-cell-lymphomas and are being tested in clinical trials. Furthermore the option of combining targeted therapies, in which antibodies are used with radiotherapy, has led to the development of radio-immunotherapies that are now becoming available for clinical use. Current results in the treatment of advanced indolent lymphomas are promising, and their use in high-grade lymphoma and as first-line therapy is under investigation. This article summarizes the application of these novel immunotherapies and reviews the results of recent clinical trials, with particular emphasis on indications and practical aspects in everyday clinical life.

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