Der Urologe

, Volume 51, Issue 3, pp 357–362 | Cite as

Zweitlinientherapie beim kastrationsresistenten Prostatakarzinom (CRPC)

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Zusammenfassung

Pro Jahr sterben in Deutschland ungefähr 12.000 Männer an einem kastrationsresistenten Prostatakarzinom, obwohl durch die PSA-basierte Früherkennung mehr kurativ behandelbare Patienten diagnostiziert werden. Als Erstlinientherapie im kastrationsresistenten Stadium ist die 3-wöchentliche Docetaxel-Therapie etabliert – diese bietet einen etwa 2-monatigen Überlebensvorteil. Nach durchschnittlich 6–9 Monaten werden alle primär mit Docetaxel chemotherapierten Patienten progredient, so dass eine sekundäre systemische Therapie indiziert ist. Das zunehmende Verständnis der Signaltransduktion der Tumorzellen hat die Entwicklung neuer Medikamente möglich gemacht. Bislang sind hier vorzugsweise Cabazitaxel, Sipuleucel-T und Abiraterone als vielversprechende Substanzen zu benennen. Künftige Untersuchungen werden eine Vielzahl an Möglichkeiten für verschiedene Kombinationstherapien, Sequenztherapien oder auch andere Therapiemodalitäten bereitstellen, von denen die Männer mit einem metastasierten kastrationsresistenten Prostatakarzinom profitieren.

Schlüsselwörter

Zweitlinientherapie Prostatakarzinom Androgenrezeptor Signaltransduktion Gesamtüberleben 

Second line therapy for castration-resistant prostate cancer (CRPC)

Abstract

Every year in Germany approximately 12,000 men die of castration-resistant prostate cancer even though early detection using PSA-based diagnostics allows more patients to be diagnosed with a curable cancer. An established first line therapy at this stadium is docetaxel chemotherapy, given in a 3-week regimen, providing an overall survival advantage of 2 months. In 6-9 months, the patients treated primarily with docetaxel will progress to a docetaxel-insensitive phase which requires a secondary systemic therapy. Increasing understanding of molecular signal transduction has permitted a growing variety of promising modern drugs, including cabazitaxel, sipuleucel-T and abiraterone. More prospective clinical data will provide a large variety of different therapy combinations, sequence therapies or other therapy regimens particularly for selected subgroups of patients with castration-resistant prostate cancer.

Keywords

Second line therapy Prostate cancer Androgen receptor Signal transduction Overall survival 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Klinik für Urologie, onkologische Urologie und KinderurologieKrankenhaus DürenDürenDeutschland

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