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TumorDiagnostik & Therapie 2022; 43(08): 523-529
DOI: 10.1055/a-1851-3276
Übersicht
Schwerpunkt

Systemtherapie des metastasierten Prostatakarzinoms

Gunhild von Amsberg
,
Ken Herrmann
,
Boris Hadaschik
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Die Therapie des metastasierten Prostatakarzinoms (PCa) hat sich in den vergangenen Jahren grundlegend gewandelt. Während die Androgenentzugstherapie (ADT) und konventionelle chemotherapeutische Behandlungsansätze lange Zeit die einzigen Behandlungsoptionen darstellten, hat ein wachsendes Krankheitsverständnis die Entwicklung neuer therapeutischer Strategien ermöglicht. Der folgende Übersichtsartikel soll einen Einblick in aktuelle und künftige Behandlungsansätze geben.
Kernaussagen

  • Unterschiedliche Phase-III-Studien zeigen einen eindeutigen und klinisch relevanten Vorteil für die frühe Therapieintensivierung in der hormonsensitiven Situation mit Docetaxel, NHA oder einer Triple-Therapie (ADT+ NHA+Docetaxel).

  • Eine ADT-Monotherapie sollte nur noch im Einzelfall bei erheblicher Komorbidität und/oder hohem Alter zum Einsatz kommen.

  • Die Therapiesequenz in der Kastrationsresistenz richtet sich nach den Vortherapien, der Symptomlast und den Komorbiditäten.

  • Mit Olaparib steht die erste Biomarker-basierte Behandlung für BRCA1/2-mutierte Patienten zur Verfügung.

  • Die PSMA-RLT ist eine attraktive neue Behandlungsoption mit guter Verträglichkeit. Eine Zulassung wird in Kürze erwartet.

  • Ein wachsendes Verständnis für molekularpathologische Vorgänge wird weitere zielgerichtete Behandlungsansätze ermöglichen.



Publikationsverlauf

Artikel online veröffentlicht:
04. Oktober 2022

© 2022. Thieme. All rights reserved.

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