Download PDF
Aktuelle Urol 2015; 46(01): 66-70
DOI: 10.1055/s-0034-1396859
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Biomarker beim metastasierten kastrationsresistenten Prostatakarzinom

Biomarkers in Metastatic Castration-resistant Prostate Cancer
K. Miller
Further Information

Publication History

Publication Date:
06 February 2015 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Durch medizinische Fortschritte der letzten Jahre ist die Therapie des metastasierten, kastrationsresistenten Prostatakarzinoms (mCRPC) sehr komplex geworden. Anders als lange Zeit zuvor gibt es heute eine Reihe von Erst- und auch Zweitlinienoptionen. Im Mittelpunkt der Forschung stehen derzeit mögliche Sequenzen und Kombinationen. Auch Biomarker spielen eine wichtige Rolle, weil sie Therapieentscheidungen erleichtern und eine individueller auf den Tumor zugeschnittene Therapie ermöglichen können. Da sich die Biologie des Tumors ändert, müssen diese für das fortgeschrittene Stadium neu evaluiert werden. Zu prognostischen Markern beim mCRPC gehört der PSA-Wert, der in diesem Stadium jedoch mit Vorsicht zu interpretieren ist. Validierte prädiktive Faktoren für das mCRPC gibt es bislang nicht. Potentielle prädiktive Marker wurden jedoch bereits in mehreren Studien analysiert.

Abstract

Therapy for metastatic castration-resistant prostate cancer (mCRPC) has become more complex due to recent medical findings. Today different options for first- and second-line treatment are available. Therefore scientific attention focuses on possible sequences and combinations. Besides, biomarkers play an important role as they can support therapeutic decisions and may enable more focused therapies. A new evaluation of biomarkers for advanced prostate cancer is necessary since the tumour biology is changing. One prognostic marker in mCRPC is PSA but this marker has to be interpreted with caution in this situation. Validated predictive markers for mCRPC are still lacking. In some studies potential predictive markers have been analysed.

Schlüsselwörter

Biomarker - prädiktive Marker - prognostische Marker - Abirateronacetat - Abirateron - Enzalutamid

Key words

biomarkers - predictive markers - prognostic markers - abiraterone acetate - abiraterone - enzalutamide
 

  • Literatur

  • 1 Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF). Interdisziplinäre Leitlinie der Qualität S3 zur Früherkennung, Diagnose und Therapie der verschiedenen Stadien des Prostatakarzinoms. Version 3.0 – 2. Aktualisierung 2014. Verfügbar http://leitlinienprogramm-onkologie.de [Abgerufen am 14.11.2014]
    PubMedGoogle Scholar
  • 2 Mottet N, Bastian PJ, Bellmunt J et al. Guidelines on Prostate Cancer. ©European Association of Urology, Update April 2014. Verfügbar http://www.uroweb.org/guidelines/ [Abgerufen am 9.9.2014]
    PubMedGoogle Scholar
  • 3 Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther 2001; 69: 89-95
    CrossrefPubMedGoogle Scholar
  • 4 Chen TW, Bedard PL. Personalized medicine for metastatic breast cancer. Current opinion in Oncology 2013; 25: 615-624
    CrossrefPubMedGoogle Scholar
  • 5 Duffy MJ, Lamerz R, Haglund C et al. Tumor markers in colorectal cancer, gastric cancer and gastrointestinal stromal cancers: European group on tumor markers 2014 guidelines update. Int J Cancer 2014; 134: 2513-2522
    CrossrefPubMedGoogle Scholar
  • 6 Armstrong AJ, Eisenberger MA, Halabi S et al. Biomarkers in the management and treatment of men with metastatic castration-resistant prostate cancer. Eur Urol 2012; 61: 549-559
    CrossrefPubMedGoogle Scholar
  • 7 Dancey JE, Dobbin KK, Groshen S et al. Guidelines for the development and incorporation of biomarker studies in early clinical trials of novel agents. Clin Cancer Res 2010; 16: 1745-1755
    CrossrefPubMedGoogle Scholar
  • 8 Armstrong AJ, Garrett-Mayer ES, Yang YC et al. A contemporary prognostic nomogram for men with hormone-refractory metastatic prostate cancer: a TAX327 study analysis. Clin Cancer Res 2007; 13: 6396-6403
    CrossrefPubMedGoogle Scholar
  • 9 Ryan CJ, Londhe A, Molina A et al. Relationship of baseline PSA and degree of PSA decline to radiographic progression-free survival (rPFS) in patients with chemotherapy-naive metastatic castration-resistant prostate cancer (mCRPC): Results from COU-AA-302. J Clin Oncol 2013; 31 (suppl abstr 5010)
    PubMedGoogle Scholar
  • 10 Kantoff PW, Higano CS, Shore ND et al. Sipuleucel-T immunotherapy for castration-resistant prostate cancer. N Engl J Med 2010; 363: 411-422
    CrossrefPubMedGoogle Scholar
  • 11 Thuret R, Massard C, Gross-Goupil M et al. The postchemotherapy PSA surge syndrome. Ann Oncol 2008; 19: 1308-1311
    CrossrefPubMedGoogle Scholar
  • 12 Scher HI, Halabi S, Tannock I et al. Design and end points of clinical trials for patients with progressive prostate cancer and castrate levels of testosterone: recommendations of the Prostate Cancer Clinical Trials Working Group. J Clin Oncol 2008; 26: 1148-1159
    CrossrefPubMedGoogle Scholar
  • 13 Goodman Jr OB, Fink LM, Symanowski JT et al. Circulating tumor cells in patients with castration-resistant prostate cancer baseline values and correlation with prognostic factors. Cancer Epidemiol Biomarkers Prev 2009; 18: 1904-1913
    CrossrefPubMedGoogle Scholar
  • 14 de Bono JS, Scher HI, Montgomery RB et al. Circulating tumor cells predict survival benefit from treatment in metastatic castration-resistant prostate cancer. Clin Cancer Res 2008; 14: 6302-6309
    CrossrefPubMedGoogle Scholar
  • 15 Scher HI, Heller G, Molina A et al. Evaluation of Circulating Tumor Cells (CTCs) as an Efficacy Response Biomarker of Overall Survival (OS) in Metastatic Castration-Resistant Prostate Cancer (mCRPC): Updated OS Analysis of COU-AA-301, a Randomized, Double-Blind, Placebo-Controlled Phase 3 Study of Abiraterone Acetate (AA) Plus Low-dose Prednisone (P) Post Docetaxel. J Clin Oncol 2011; 29 (suppl abstr LBA4517 (oral presentation))
    PubMedGoogle Scholar
  • 16 Dossier zur Nutzenbewertung gemäß § 35a SGB V Janssen-Cilag GmbH, Abirateronacetat (Zytiga®), Modul 4 A., Stand 14.01.2013. Verfügbar www.g-ba.de/informationen/nutzenbewertung/60/ [Abgerufen am 24.7.2013]
    PubMed
  • 17 Rathkopf DE, Smith MR, de Bono JS et al. Updated Interim Efficacy Analysis and Long-term Safety of Abiraterone Acetate in Metastatic Castration-resistant Prostate Cancer Patients Without Prior Chemotherapy (COU-AA-302). Eur Urol 2014; DOI: 10.1016/j.eururo.2014.02.056. [Epub ahead of print]
    PubMedGoogle Scholar
  • 18 Attard G, De Bono JS, Li W et al. ERG rearrangements and association with clinical outcome in patients (pts) receiving abiraterone acetate (AA): Results from the COU-AA-302 study in chemotherapy (chemo)-naïve metastatic castration-resistant prostate cancer (mCRPC). J Clin Oncol 2013; 31 (suppl abstr 5004)
    PubMedGoogle Scholar
  • 19 Leibowitz-Amit R, Templeton AJ, Atenafu EG et al. Novel predictive markers of PSA response to abiraterone acetate in men with metastatic castration-resistant-prostate-cancer (mCRPC). J Clin Oncol 2013; 31 (suppl abstr 5058)
    PubMedGoogle Scholar
  • 20 Antonarakis ES, Lu C, Wang H et al. AR-V7 and resistance to enzalutamide and abiraterone in prostate cancer. N Engl J Med 2014; 371: 1028-1038
    CrossrefPubMedGoogle Scholar