Nashan D, Luger T A
Universitäts-Hautklinik Münster und Ludwig Boltzmann Institut für Zellbiologie und Immunbiologie der Haut.
Hautarzt. 2001 Aug;52(8):691-6. doi: 10.1007/s001050170082.
Various therapeutic options using cytokines have been described in the treatment of melanoma, T cell lymphoma, B cell lymphoma, squamous cell carcinoma, basal cell carcinoma and Merkel cell carcinoma. The treatment regimens include cytokine substitution, cytokine induction, cytokine transfection and therapeutic cytokine constructs. In the adjuvant treatment of melanomas, IFN-alpha has become well established. Statistical evaluations of different adjuvant trials show that a significant prolongation of recurrence-free intervals can be achieved. IL-2 has a role in the therapy of advanced melanomas as well as in vaccination strategies. Further possible therapeutic immune modulations, which have been evaluated in experimental approaches and pilot studies, include treatment with IL-4, IL-7 and GM-CSF. Treatment with IL-12 promises to open new perspectives. A well established regimen in the treatment of T cell lymphoma stages Ia-IIb is the combination of PUVA and IFN-alpha. In vitro data also indicate an important (patho)physiological role for IL-12, so that this agent has been tested in phase I studies. IL-2, IFN-gamma, and the fused cytokine-toxin molecules DAB389IL-2 offer further therapeutic alternatives. B cell lymphomas are treated with antibody-IL-2 fusion proteins. Advanced or inoperable squamous cell carcinoma and basal cell carcinoma may be treated with local IFN-alpha injections. IFN-alpha or TNF-alpha may be considered for the treatment of recurrent or advanced Merkel cell carcinoma. In dermatological oncology cytokine treatment focuses on melanome an T cell lymphome. Cytokine application is mainly an integral part of multimodal regimens.
在黑色素瘤、T细胞淋巴瘤、B细胞淋巴瘤、鳞状细胞癌、基底细胞癌和默克尔细胞癌的治疗中，已经描述了多种使用细胞因子的治疗选择。治疗方案包括细胞因子替代、细胞因子诱导、细胞因子转染和治疗性细胞因子构建体。在黑色素瘤的辅助治疗中，α干扰素已得到广泛应用。对不同辅助试验的统计评估表明，可以显著延长无复发生存期。白细胞介素-2在晚期黑色素瘤的治疗以及疫苗接种策略中都有作用。在实验方法和试点研究中评估的其他可能的治疗性免疫调节包括用白细胞介素-4、白细胞介素-7和粒细胞-巨噬细胞集落刺激因子进行治疗。用白细胞介素-12治疗有望开辟新的前景。在T细胞淋巴瘤Ia-IIb期的治疗中，一个成熟的方案是补骨脂素加紫外线A（PUVA）和α干扰素联合使用。体外数据也表明白细胞介素-12具有重要的（病理）生理作用，因此该药物已在I期研究中进行了测试。白细胞介素-2、干扰素-γ和融合细胞因子-毒素分子DAB389IL-2提供了更多的治疗选择。B细胞淋巴瘤用抗体-白细胞介素-2融合蛋白治疗。晚期或无法手术的鳞状细胞癌和基底细胞癌可用局部注射α干扰素治疗。对于复发性或晚期默克尔细胞癌，可考虑用α干扰素或肿瘤坏死因子-α治疗。在皮肤肿瘤学中，细胞因子治疗主要集中在黑色素瘤和T细胞淋巴瘤。细胞因子的应用主要是多模式治疗方案的一个组成部分。
