PSA-Progression unter Hormontherapie – prognostische Relevanz

Zusammenfassung

Die medikamentöse antihormonelle Therapie des Prostatakarzinoms wird im klinischen Alltag durch regelmäßige Kontrollen des PSA Wertes gesteuert. Der PSA Anstieg wird als erstes Zeichen der Progression und damit für ein Versagen der Therapie gewertet. Beim hormonsensitiven Prostatakarzinom ist damit das erste Stadium der Kastrationsresistenz erreicht. Die Frage des Zusammenhangs zwischen PSA Progression und Gesamtüberleben als wichtigstem klinischen Endpunkt wurde in 2 Untersuchungen retrospektiv evaluiert. In beiden konnte der Zusammenhang bestätigt werden. Allerdings kommt der PSA Progression beim Therapievergleich z. B. in Phase-III-Studien kein Surrogat Status zu, da sich in den zurzeit verfügbaren Analysen kein eindeutiger Zusammenhang zwischen dem Therapieeffekt auf PSA Progression und auf das Gesamtüberleben herstellen lässt.

Abstract

In clinical routine, the anti-hormone therapy for prostate cancer with drugs is monitored by regular control measurements of the PSA value. An increase in the PSA value is considered to be a first sign of progression and thus of failure of the therapy. In the case of hormone-sensitive prostate carcinoma this means that the first stage of castration resistance has been reached. The question as to the relationship between PSA progression and overall survival as the most important clinical endpoint has been evaluated retrospectively in 2 studies. Both were able to confirm the relationship. However, in a therapy comparison, e.g., in phase III studies, the PSA progression does not have a surrogate status since the currently available analyses do not allow the recognition of an unambiguous relationship between the therapeutic effect on PSA progression and overall survival

Schlüsselwörter

Prostatakarzinom - antihormonelle Therapie - PSA Progression - Gesamtüberleben

Key words

prostate cancer - androgen deprivation therapy - PSA progression - overall survival

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