Anti-Angiogenese - ein Therapiekonzept zur Behandlung von Kopf-Hals-Karzinomen?[1]

 

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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.

1 Herrn Prof. Dr. med. Ulrich Koch zum 60. Geburtstag gewidmet.

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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