Ziel: 20 statt 50! Aktuelle Daten zum Zielwert der Testosteronsenkung und die Forschung hierüber seit erster „LH-RH“ (GnRH)-Analoga-Gabe an Patienten vor 40 Jahren

Peter Hammerer; Walther Grohmann; Axel S. Merseburger

doi:10.1055/a-1121-7400

Aktuelle Urol 2020; 51(06): 552-556
DOI: 10.1055/a-1121-7400

Übersicht

Ziel: 20 statt 50! Aktuelle Daten zum Zielwert der Testosteronsenkung und die Forschung hierüber seit erster „LH-RH“ (GnRH)-Analoga-Gabe an Patienten vor 40 Jahren

Current data on the target value of testosterone lowering and the associated research since the first administration of LHRH (GnRH) analogues to patients 40 years ago

Peter Hammerer

¹Städtisches Klinikum Braunschweig gGmbH, Chefarzt der Klinik für Urologie, Braunschweig

,

Walther Grohmann

²Private, Urology, 80637 München

,

Axel S. Merseburger

³Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Urologie, Lübeck

› Author Affiliations

Abstract

Zusammenfassung

Beim ersten Einsatz eines LH-RH (heute: GnRH)-Analogon zur Therapie des Prostatakarzinoms war das Kastrationsniveau von unter 50 ng/dl willkürlich festgelegt. Seither zeigen zahlreiche Untersuchungen, dass mit einer dauerhaften Senkung des Testosteronspiegels, wie z. B. durch Buserelin, auf Werte von unter 20 ng/dl eine deutliche Verbesserung des Outcome einhergeht. Dies wird in aktuellen Studien belegt, sodass der Kastrationsspiegel mit Werten von unter 20 ng/dl zu fordern ist. Darüber hinaus stellt der Hormonentzug mit GnRH-Analoga weiterhin die Basistherapie für neue Therapieoptionen wie z. B. mit Abirateron, Enzalutamid bzw. Apalutamid dar.

Abstract

When LH-RH (now: GNRH) analogues were first used for the treatment of prostate cancer, the castration level was arbitrarily defined as a testosterone level of less than 50 ng/dl. Since then, numerous studies have shown that a permanent lowering of the testosterone level, e. g. by buserelin, to values lower than 20 ng/dl is associated with a significant improvement in outcomes. This has been proven in recent studies. Therefore, a castration level with testosterone values of less than 20 ng/dl is required. In addition, hormone withdrawal with GNRH analogues continues to provide the basic therapy for new treatment options, e. g. with abiraterone, enzalutamide or apalutamide.

Schlüsselwörter

Kastrationsniveau - Testosteronsenkung - Buserelin - LHRH - ADT

Keywords

testosterone reduction - buserelin - LHRH - ADT - castration level

Full Text

References

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