Der Urologe

, Volume 51, Issue 1, pp 39–43 | Cite as

Rolle der Chemotherapie beim kastrationsresistenten Prostatakarzinom

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Leitthema
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Zusammenfassung

Chemotherapieoptionen in der Behandlung des metastasierten kastrationsresistenten Prostatakarzinoms (CRPC) waren bis vor kurzem sehr limitiert. Mitoxantron war in den 1990er Jahren aufgrund seiner palliativen Wirksamkeit zugelassen worden. Erst mit der Einführung von Docetaxel brachen neue Zeiten in der Therapie des CRPC an. Prednison und Docetaxel alle 3 Wochen zeigten einen Overall-survival- (OS-)Benefit gemeinsam mit einer Verbesserung der Lebensqualität und einer Schmerzreduktion. Weitere chemotherapeutische Therapiestrategien sind eine Reinduktion mit Docetaxel nach Ansprechen auf die Erstlinientherapie. Cabazitaxel, ein neu entwickelter semisynthetisch hergestellter Mikrotubulusinhibitor, wurde vor kurzem für die Behandlung des CRPC nach Docetaxel zugelassen. Dieser Überblicksartikel soll durch die Chemotherapieoptionen führen und eine Hilfestellung für die Optimierung der Chemotherapien im klinischen Alltag geben.

Schlüsselwörter

Prostatakarzinom, kastrationsresistentes Chemotherapie Docetaxel Cabazitaxel Lebensqualität 

Role of chemotherapy in castration-resistant prostate cancer

Are there new approaches?

Abstract

Chemotherapy options for the treatment of metastatic castration-resistant prostate cancer (CRPC) have been very limited for many decades. Until 2004, only mitoxantrone was approved, providing palliation, but no survival benefit. With the introduction of docetaxel, the landscape of chemotherapy for CRPC changed substantially. Prednisone and three-weekly docetaxel showed an overall survival (OS) benefit compared to mitoxantrone plus prednisone, in addition to a significant improvement of quality of life and pain reduction. Further strategies to treat CRPC with chemotherapy include reinduction with docetaxel in responding patients and the use of cabazitaxel, a novel semi-synthetic microtubule inhibitor, in the docetaxel-refractory population. This review article is meant to guide physicians through the optimal use of chemotherapy in CRPC patients in daily clinical practice.

Keywords

Prostate cancer, castration-resistant Chemotherapy Docetaxel Cabacitaxel Quality of life 

Notes

Interessenskonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: M. De Santis Honorare für Beratungstätigkeit (Advisory Boards): Amgen, Bayer, Dendreon, Eli Lilly, GSK, Janssen Cilag, Novartis, Pfizer, Pierre-Fabre Oncology, Roche, Sanofi Aventis, Astellas, OncoGenix/Teva.

M. Bachner Honorare (speaker’s fees): Novartis, Takeda.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.3. Medizinische Abteilung, Zentrum für Onkologie und Hämatologie, Angewandte Krebsforschung – Institution für Translationale Forschung Wien (ACR-ITR VIEnna)Kaiser Franz Josef-Spital – SMZ SüdWienÖsterreich

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