Molekulare Testung des Prostatakarzinoms: wann, wie und mit welcher Konsequenz?

Zusammenfassung

Das metastasierte Prostatakarzinom ist eine heterogene Erkrankung. Bislang basiert die Behandlungsentscheidung meist auf der Tumorausdehnung und -symptomlast, Begleiterkrankungen und dem Patientenwunsch. Molekularpathologische Aspekte fließen nur selten ein.

Kostenrückgang und zunehmende Verbreitung des Next Generation Sequencing (NGS) haben zu einer Zunahme der molekularen Testung und einem besseren Verständnis der Bedeutung molekularer Alterationen für die Entstehung und Ausbreitung des Prostatakarzinoms geführt. Eine konsequentere Testung konstitutioneller Genveränderungen („Keimbahntestung“) deckt hereditäre Prädispositionen auf. Nach der Zulassung von Olaparib zur Therapie BRCA1/2 mutierter, kastrationsresistenter Prostatakarzinome befinden sich weitere zielgerichtete Therapieansätze in der Entwicklung.

In unserem Übersichtsartikel geben wir einen Überblick zur aktuellen molekularen Testung beim Prostatakarzinom und diskutieren mögliche Konsequenzen.

Abstract

Metastatic prostate cancer is a heterogeneous disease. To date, however, treatment decisions are often based on the extent and symptom burden of the tumour, concomitant diseases, and the patient’s wishes. Molecular pathology aspects are rarely taken into account.

Declining costs and the increasing use of next-generation sequencing (NGS) have led to an increase in molecular testing and a better understanding of the significance of molecular alterations for the development and spread of prostate cancer. More consistent germline testing reveals hereditary predispositions.

Following the approval of olaparib for the treatment of BRCA1/2 mutated, castration-resistant prostate cancer, further targeted therapeutic approaches are currently under development.

In our review article, we provide an overview of current molecular testing in prostate cancer and discuss possible consequences.

Schlüsselwörter

Somatische Testung - Keimbahntestung - konstitutionelle Genveränderungen - zielgerichtete Therapie - PARP-Inhibitoren

Keywords

Somatic testing - germline testing - constitutional gene alterations - targeted therapy - PARP inhibitors

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