Immuntherapie beim malignen Melanom

Immunotherapy of malignant melanoma

The malignant melanoma is because of its ability to form metastasis even at early stages of disease the deadliest of all skin tumors. Its incidence rises faster than that of any other human tumor. Today, treatment of melanoma is based on surgical removal, and depending on the stage, chemotherapy and/or biological response modifiers. The response and„cure rates are, however, not satisfactory and there is, therefore, ongoing research for other approaches. The identification of melanoma antigenic peptides like Melan-A, gp100 and ras peptides has opened new possibilities in the treatment of malignant melanoma. The research on generating mainly T cell mediated immune responses against malignant melanoma using many different approaches like injection of dendritic cells pulsed with melanoma specific peptides, injection of in vitro with cytokines stimulated T cells, immunization with peptides in the presence of different adjuvants, immunization with genetically modified melanoma cells etc. has produced many encouraging results. However, the future of tumor„vaccine development still lies in generation of more potent vaccination protocols.

Zusammenfassung

Das maligne Melanom ist, dank seiner Fähigkeit schon in frühen Stadien Metastasen zu bilden, der gefährlichste aller Hauttumoren. Er ist der Tumor mit dem zur Zeit schnellsten Inzidenzanstieg. Die Therapie des malignen Melanoms basiert in erster Linie auf chirurgischen Maßnahmen. Abhängig vom Stadium werden auch Chemotherapien oder Immunmodulatoren eingesetzt. Da bei fortgeschrittenen Stadien alle diese Therapien nur eine begrenzte Wirksamkeit zeigen, sind neue Strategien gefragt. Die Entdeckung antigener auf Melanomzellen vorkommender Peptide (z. B. Melan-A gp100, ras-Peptide etc.) hat in der Therapie des malignen Melanoms neue Möglichkeiten eröffnet. Heutzutage wird intensiv nach Strategien zur Erzeugung starker v. a. T-Zell-vermittelter Immunreaktionen gegen das maligne Melanom gesucht. Die hierbei angewendeten Methoden - Injektion von mit Melanoma-spezifischen Peptiden geladenen dendritischen Zellen, Injektion von in vitro mit Zytokinen stimulierten T-Zellen, Peptidimmunisierungen mit verschiedenen Adjuvantien, Immunisierung mit genetisch modifizierten Melanomzellen etc. - zeigen ermutigende Resultate. Die Zukunft einer erfolgreichen Tumorimmunisierung liegt jedoch nach wie vor in der Erzeugung von wirksameren Immunisierungsprotokollen.

Key words

Melanoma - immunotherapy - cancer vaccination - peptide immunization - ras mutations

Schlüsselwörter

Melanom - Immuntherapie - Krebsimpfung - Peptidimmunisierung - RAS-Mutationen

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