Der Urologe (Impact Factor: 0.44). 01/2012; 51(1):44-49. DOI: 10.1007/s00120-011-2712-6


Die Immuntherapie und Tumorzellvakzinierung ist eine herausfordernde Therapieoption beim Prostatakrebs, zumal Nebenwirkungen
nur selten auftreten. In diesem Review werden aktuelle Entwicklungen in der Vakzinierungstherapie des Prostatakarzinoms diskutiert.
Die FDA-genehmigte antigenpräsentierende Zellvakzine Sipuleucel-T wird im Detail beschrieben, ebenso wie neue Strategien in
der Immuntherapie wie die der RNA und Peptidvakzinierung. Derzeit ist der Erfolg einer Prostatakrebsvakzinierung immer noch
mit Einschränkungen verbunden. Die immunsuppressive Wirkung des Tumors im lokalen Mikroenvironment und die Ausbildung regulatorischer
T-Zellen, die das Immunsystem in seiner Effektorfunktion unterdrücken, limitieren den Therapieerfolg. Das Konzept der immunologischen
„Schnittstellen-Checkpointmodulation“ beschreibt die gezielte Beeinflussung immunologischer Schnittstellen, um Toleranzmechanismen
zu durchbrechen und die Immunantwort zu steigern. Mögliche klinische Mechanismen einer Checkpointmodulation werden skizziert.

Immune therapy and tumor cell vaccination is a challenging option in prostate cancer therapy, especially as side effects rarely
occur. This review highlights recent developments in vaccination therapy of prostate cancer. The FDA approved antigen presenting
cell vaccine Sipuleucel-T is described and new strategies of immune therapy like RNA and peptide vaccination are discussed
in detail. Currently the effect of prostate cancer vaccination has still limitations, at least partially due to the immune
suppressive effects of the tumor microenvironment and regulatory T cells, which suppress the immune effector function. To
overcome these hurdles the concept of immune checkpoint modulation, which has the aim to break tolerance mechanisms, is discussed.
Potential clinical therapies of checkpoint modulation are outlined.

SchlüsselwörterProstatakarzinom–Vakzinierung–T-Zell-Aktivierung–Mikroenvironment des Tumors–Sipuleucel-T
KeywordsProstate carcinoma–Vaccination–T-cell activation–Specific immune therapy–Sipuleucel-T

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