Gentherapeutische Ansätze bei gastrointestinalen Tumoren

Zusammenfassung

Gentherapie ist eine elegante und grundsätzlich nebenwirkungsarme Alternative zu herkömmlichen Therapiestrategien bei Malignomen. Nach dem Enthusiasmus der 90er-Jahre ist Ernüchterung eingekehrt. Im Rahmen dieser Arbeit werden die Werkzeuge und Stellschrauben der Gentherapie (Vektoren, Promotoren, Targeting, therapeutische Gene) sowie die Wirkprinzipien (Enzym-Prodrug-Therapie; genetische Impfung) erklärt. Die klinischen Protokolle und die wenigen abgeschlossenen klinischen Studien zu gastrointestinalen Tumoren werden kritisch reflektiert und ein Ausblick auf die weitere Entwicklung - auch jenseits der klassischen Gentherapie - gegeben.

Abstract

Gene therapy offers an elegant alternative to toxic chemotherapy regimens, mostly without severe side effects. Gene therapy for cancer was one of the first applications. Following the enthusiasm in the early 1990 s, a more rationale view is preferred today. This general review looks at the tools of gene therapy and their principle elements (vector, promoter, targeting, therapeutic genes). The principles of gene therapy such as gene-directed enzyme prodrug therapy (GDEPT) and gene-directed tumor vaccination are explained. Furthermore, published protocols and clinical studies in gastrointestinal oncology are reviewed. Finally, an outlook is given on the latest developments, some of them going beyond the realm of conventional gene therapy.

Schlüsselwörter

Gentherapie - Lebermetastasen - Pankreaskarzinom

Key words

Gastroenteropancreatic tumors - gene therapy - pancreatic carcinoma - liver metastases

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1 Alle Abkürzungen finden sich im Glossar am Ende des Artikels