Antikörper Pamrevlumab bei radiogen induzierter Lungenfbrose?

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Metastasentherapie bei malignem Melanom mit unbekanntem Primärtumor

Malignant melanoma from unknown primary tumor is always a metastatic tumorous disease. The clinical presentation is often regional tumor manifestations in skin, subcutis, soft tissue or lymph nodes but may also show visceral metastases in lungs, liver, brain, bones, spleen or gastrointestinal manifestations. Diagnosis and treatment cannot always be separated. As multiple sites are frequently involved the individual treatment plan should be devised by an interdisciplinary tumor board after whole body staging. Documented local metastases in skin, soft tissue or lymph nodes are classified as stage III melanoma and treated accordingly. The prognosis has been shown to be equal to or even better than in cases with known primary tumor. Even after curative resection further recurrences are common but can often be re-resected with curative intent. Palliative treatment options, such as interventional procedures, radiotherapy, chemotherapy, novel kinase inhibitors and immunotherapy depend on tumor extent and the sites of the metastases.     

Bispezifische Antik?rper

Bispecific antibodies are able to redirect activated immunocompetent cells against simultaneously targeted tumor cells, which results in effective tumor cell lysis. After initial disappointing attempts, various novel concepts showed promising results for clinical effective therapy: the trifunctional antibody catumaxomab (EpCAM x CD3) was approved by the European Medical Agency to treat malignant ascites in patients with peritoneal carcinomatosis. BiTE (bispecific T-cell engager) molecules showed significant efficacy in phase?II trials in patients with CD19-positive acute lymphatic leukemia. In this article, new developments in the field of bispecific molecules are evaluated from a clinical perspective.     

Antik?rper zur adoptiven Immuntherapie solider Tumoren

Monoclonal antibodies have been successfully introduced into medical therapy of patients with solid cancers. These recombinant immunoglobulins bind specific structures (epitopes) on the surface of cancer cells (cancer antigens) or they interact with targets in the tumor environment. Blocking of growth factor receptor signaling, neutralization of growth factors, recruitment of immune effectors to activate antibody dependent cytotoxicity (ADCC) and/or complement-mediated lysis and triggering cell-intrinsic death pathways are regarded as key effector mechanisms of therapeutic antibodies. In addition, antibody conjugates are used to target toxins or radionuclides to cancer cells. The toxicity profile of clinically applied antibodies is determined by the expression of their respective epitopes in normal tissues. In addition, antibodies may provoke anaphylactic reactions by activation of immune effector cells and cytokine release. To date six antibodies have been approved for therapeutic use in solid cancer patients in Germany (Bevacizumab, Cetuximab, Denosumab, Ipilimumab, Panitumumab and Trastuzumab). Several novel antibodies are currently in clinical testing.     

Monoklonale Antik?rper in der Therapie von Tumorerkrankungen

Monoclonal antibodies (mAbs) are industrially produced immunoglobulins that bind to specific protein epitope targets. They play an increasing role as therapeutic agents in the treatment of cancer. MAbs inhibit tumor growth by blocking receptors and manipulating tumor-related signaling or by enhancing the host immune response and targeting factors produced by the tumor. They are also effective in conjugation with radio isotopes or chemotherapy. The adverse effects of mAbs are related to their specific target and to their immunomodulatory properties, which can cause hypersensitivity, immunosuppression, immunostimulation and autoimmunity. In Germany, eight unconjugated (rituximab, cetuximab, panitumumab, alemtuzumab, trastuzumab, bevacizumab, ofatumumab, catumaxomab) and one conjugated (⁹⁰Yttrium-ibritumomab tiuxetan) mAbs are currently approved for the treatment of malignancies.     

Fertilit?tserhalt bei Krebs

CME Weiterbildung · Zertifizierte Fortbildung

Fertilit?tserhalt bei Krebs     

Krebsrisiko bei Nachkommen nach Kinderwunschbehandlung?

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Aktuelle Therapiestrategien bei follikul?ren Lymphomen

Follicular lymphomas are the second most frequent lymphoma entity following diffuse large cell B-cell lymphoma. The clinical course is slowly progressive so that they belong to the group of indolent lymphomas. For the few patients where the disease is diagnosed in localized stages I or II radiotherapy is indicated. In advanced stages III and IV a watch and wait strategy is indicated when there is a lack of clinical symptoms. If treatment is indicated immunochemotherapy followed by a 2-year rituximab maintenance comprises the standard of care.     

Fertilit?tserhalt bei Patienten mit malignen Erkrankungen

M?glichkeiten des Fertilit?tserhaltes sollten als Bestandteil jeder onkologischen Therapieplanung mit dem Patienten/der Patientin besprochen werden. Nach Auslegung des deutschen ESchG stehen neben der Kryokonservierung von 2PN-Zygoten die Tiefkühllagerung von Oozyten und Spermien zur Verfügung. Andere Methoden sind viel versprechend, befinden sich aber bislang noch im experimentellen Stadium. Der vorliegende Beitrag soll dem Leser aktuelle Therapieempfehlungen zum Fertilit?tserhalt junger Patienten bei onkologischen Erkrankungen aufzeigen und in die aktuelle Studienlage einführen.     

Moderne Diagnostik bei akuten und chronischen Leuk?mien

The diagnostics of hematological diseases is a difficult task. Leukemia shows a broad spectrum of phenotypic and genotypic heterogeneity and clinical outcome varies greatly. Currently the combination of several diagnostic methods, such as cytomorphology, histology, immunophenotyping, chromosome banding analysis, fluorescence in situ hybridization and several molecular techniques offer the opportunity to classify specific leukemia subtypes, define prognosis and individualize patient treatment.     

Chirurgische Therapie von prim?ren Lebertumoren bei Erwachsenen

Surgical removal is currently the main approach in the curative treatment of primary liver tumors. The current article summarizes principle strategies of liver surgery as well as aspects in the treatment of hepatocellular carcinoma and cholangiocarcinoma. In this aspect liver resection is particularly important and in selected cases liver transplantation can be an alternative therapy.     

Einsatz mono- und bispezifischer Antikörper in der Tumortherapie

Nachdem es 1974 K?hler und Milstein [15] erstmals gelungen war, monoklonale Antik?rper (MoAk) gezielt und in gro?en Mengen gegen vorgegebene Antigene herzustellen, erlangte die passive Immuntherapie einen zunehmenden Stellenwert in der H?matologie und internistischen Onkologie. Zun?chst wurden zahlreiche neue Antik?rper generiert, die selektiv Oberfl?chenantigene auf Tumor- oder Effektor-Zellen des Immunsystems erkannten. W?hrend native monoklonale Antik?rper in vitro h?ufig eine gute zytotoxische Wirksamkeit zeigten, waren die ersten klinischen Studien wenig erfolgreich. Wissenschaftler griffen daraufhin auf eine Idee zurück, die Paul Ehrlich bereits Ende des letzten Jahrhunderts erstmals als potentielle „Zauberkugeln” gegen den Krebs formuliert hatte: Monoklonale Antik?rper werden an pflanzliche oder bakterielle Giftstoffe (Immuntoxine), Radionuklide (Radioimmunkonjugate), Enzyme, Zytokine oder Nukleins?uren [1] gekoppelt, um diese Zellgifte selektiv nur zu den malignen Zielzellen im menschlichen K?rper zu transportieren. Die monoklonalen Antik?rper bilden zwar das Grundgerüst für diese neuen Konstrukte, die nativen ungekoppelten Formen galten jedoch lange Zeit als eher unwirksam beim Menschen. Umso erstaunlicher ist es, da? es sich bei allen monoklonalen Antik?rpern, die bisher bis zur klinischen Anwendung gekommen sind oder kurz vor der Zulassung stehen, ausschlie?lich um native, d.h. nicht-gekoppelte Varianten handelt. Ausnahmen bilden der radioaktiv gekoppelte anti-CD20 Antik?rper B1, der im kommenden Jahr in den USA für die Behandlung von Non-Hodgkin-Lymphomen zugelassen werden soll, und das anti-CD33 Immuntoxin CMA-676, das z.Z. in klinischen Studien bei Patienten mit rezidivierter akuter myeloischer Leuk?mie geprüft wird.