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Der Nuklearmediziner 2008; 31(2): 164-177
DOI: 10.1055/s-2008-1004780
Neue Therapieverfahren in der Nuklearmedizin

© Georg Thieme Verlag Stuttgart · New York

Radioimmuntherapie maligner Gliome

Radioimmunotherapy of Malignant GliomasG. Pöpperl1 , K. Tatsch1
  • 1Klinik und Poliklinik für Nuklearmedizin, Klinikum der Universität München - Campus Großhadern, München
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Publication History

Publication Date:
05 June 2008 (online)

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Zusammenfassung

Trotz aller technischer Fortschritte (intraoperative Resektionskontrolle, fluoreszenzgestützte Operation, fortschrittliche Bestrahlungstechniken) und neuer Erkenntnisse in der systemischen Chemotherapie ist die Behandlung maligner Gliome mittels konventioneller Therapie (Operation, perkutane Bestrahlung und Chemotherapie) nach wie vor unbefriedigend. Eine radikale Tumorentfernung ist unmöglich, da Tumorzellen diffus in das umgebende Hirngewebe infiltrieren und jegliche Therapie durch die eingeschränkte Toleranz des umgebenden gesunden Hirngewebes limitiert ist. Neue Therapieansätze zielen daher auf eine zunehmend selektive Zerstörung von Tumorzellen ab. So exprimieren maligne Gliomzellen verschiedene Antigene oder Rezeptoren, die in gesundem Gewebe nicht oder nur in deutlich geringerem Maße vorkommen. Die Applikation radioaktiv markierter Antikörper, besonders nach lokaler Gabe, die gegen diese Zielstrukturen gerichtet sind, bietet daher einen innovativen Therapieansatz, der in vielen klinischen Phase-I- und -II-Studien bereits viel versprechende Ergebnisse bei akzeptablem Nebenwirkungsprofil gezeigt hat. Diese Übersichtsarbeit fasst eigene Erfahrungen und in der Literatur publizierte Daten zur Radioimmuntherapie maligner Gliome zusammen und zeigt mögliche zukünftige Entwicklungen zur Verbesserung dieser Therapieform auf.

Abstract

Despite all technical advances (intraoperative resection control, fluorescence guided resection, advances in external beam radiation techniques) and new consolidated findings on systemic chemotherapy treatment of malignant gliomas with conventional therapeutic modalities (surgery, radiation therapy and chemotherapy) is still highly unfavourable. Total tumor erradication is impossible due to tumor infiltrations into the normal brain and the limitations given by the limited tolerance of surrounding brain tissue. New treatment strategies, therefore, aim for a more selective destruction of tumor cells. Malignant glioma cells selectively express several antigens or receptors which are not or only to a minor extent present in normal brain tissue. Administration of radiolabelled monoclonal antibodies, especially when given locoregionally, targeting these tumor-specific antigens offers an innovative therapeutic strategy that has recently demonstrated encouraging antitumor effects and acceptable toxicity in many phase I / II clinical trials. This review offers a comprehensive summary of own experiences and results of clinical trials reported in the literature dealing with radioimmunotherapy of malignant glioma and highlights future plans to further develop this therapeutic strategy.

Schlüsselwörter

maligne Gliome - Radioimmuntherapie - intrakavitär / intratumoral - Tenascin-C

Key words

malignant gliomas - radioimmunotherapy - intracavitary / intratumoral - Tenascin C

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PD Dr. G. Pöpperl

Klinik und Poliklinik für Nuklearmedizin · Klinikum der Universität München - Campus Großhadern

Marchioninistr. 15

81377 München

Phone: +49 / 89 / 70 95 76 43

Fax: +49 / 89 / 70 95 76 46

Email: Gabriele.Poepperl@med.uni-muenchen.de

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