Zusammenfassung
Hintergrund: Plattenepithelkarzinome des Kopf-Hals-Bereichs sind heute die sechsthäufigste Malignomerkrankung
weltweit. Verbesserte Techniken in der Chirurgie, der Radiatio und der Chemotherapie
konnten zwar die lokale Kontrolle von Kopf-Hals-Karzinomen verbessern, die Überlebensrate
hat sich in den letzten 25 Jahren jedoch nicht signifikant verändert. Die Angiogenese
gilt als eines der Schlüsselphänomene für die Progression und die Metastasierung von
Kopf-Hals-Karzinomen. Inhibitoren der Angiogenese sind eine neue Klasse von anti-neoplastischen
Substanzen, die eine wirkungsvolle Ergänzung konventioneller Therapieformen darstellen
könnten. Material und Methode: Sowohl die Rolle der Angiogenese bei Kopf-Hals-Karzinomen als auch verschiedene aktuelle
präklinische sowie klinische Studien zum Einsatz von Inhibitoren der Tumorangiogenese
werden hier dargestellt und diskutiert. Ergebnisse: Zahlreiche der untersuchten Angiogenese-Inhibitoren zeigten einen antiproliferativen
Effekt auf die behandelten Tumoren mit Krankheitsstabilisierungen, Regressionen der
Tumormasse oder Remissionen. Schlussfolgerung: Eine anti-angiogene Therapie hat unzweifelhaft das Potential, konventionelle Therapieformen
zu ergänzen. Anti-angiogene Substanzen erscheinen so als vielversprechende Therapeutika
für einen klinischen Einsatz in der Behandlung von Kopf-Hals-Karzinomen.
Anti-Angiogenesis - A Treatment Strategy for Head and Neck Cancer?
Background: Head and neck squamous cell carcinoma (HNSCC) is an aggressive malignancy that is
now the sixth most common neoplasm in the world. Despite numerous advances in treatment,
the long-term survival has remained the same for the last 25 years. Angiogenesis has
been shown to be important for HNSCC tumour growth and metastasis. Therefore, inhibitors
of angiogenesis are a new class of anti-nepolastic substances that might be a powerful
complement to conventional therapy in HNSCC. Material and Methods: The role of angiogenesis in HNSCC as well as preclinical and clinical trials concerning
inhibitors of tumor-angiogenesis are discussed here. Results: Many of the investigated angiogenesis inhibitors demonstrated anti-tumor effects
in preclinical and clinical trials. In a few cases, partial remission was observed. Conclusions: Anti-angiogenic therapy will undoubtly have the potential to change standard tumor
therapies. Some anti-angiogenic substances appear to be promising candidates for a
clinical use in the therapy of HNSCC.
Schlüsselwörter:
Angiogenese - Kopf-Hals-Karzinome - Anti-Angiogenese
Key words:
Angiogenesis - Head and neck cancer - Anti-angiogenesis
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1 Herrn Prof. Dr. med. Ulrich Koch zum 60. Geburtstag gewidmet.
Dr. med. Frank Riedel
Universitäts-HNO-Klinik Mannheim
Theodor-Kutzer-Ufer
68135 Mannheim
Email: frank.riedel@hno.ma.uni-heidelberg.de