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Metastasiertes Prostatakarzinom

Positionspapier zum Einsatz der Chemotherapie

Metastasized prostate cancer

Position paper on the use of chemotherapy

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Zusammenfassung

Hintergrund

Für die Therapie des metastasierten Prostatakarzinoms (mPC) stehen sowohl antihormonelle als auch zytotoxische Therapieoptionen zur Verfügung. Da v. a. beim metastasierten kastrationsresistenten Prostatakarzinom (mCRPC) bisher keine vergleichenden Studien zur Verfügung stehen bleibt unklar, welcher Patient von welcher Therapie am besten profitiert.

Fragestellung

Bisherige Daten zur Sequenz der verschiedenen Therapieoptionen zeigen, dass die richtige Wahl der Erstlinientherapie beim mCRPC einen Einfluss auf die Prognose der Patienten haben kann. In dem Positionspapier werden die verschiedenen Therapieoptionen kritisch beleuchtet und klinische sowie pathohistologische Kriterien für die Selektion der Erstlinientherapie beim mCRPC disktutiert.

Ergebnisse

Molekulare Marker sind für die Zukunft ein wichtiges Hilfsmittel für die Patientenselektion und eine individualisierte Therapie zum optimalen Einsatz der zur Verfügung stehenden Therapien.

Abstract

Background

Antihormonal and cytotoxic therapy options are available for the therapy of metastasized prostate cancer (mPC). Because no comparative studies are available, especially for castration-resistant prostate cancer (mCRCP), it remains unclear which patients will profit best from which therapy.

Objectives

Previous data on the sequence of the various therapy options show that correct selection of the first line therapy for mCRPC can have an influence on the prognosis of the patient. In this position paper the various therapy options are critically illustrated and the clinical and pathohistological criteria for selection of the first line therapy of mCRPC are discussed.

Results

Molecular markers are an important aid for future patient selection and individualized therapy for optimal use of the available forms of therapy.

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Literatur

  1. Gemeinsamer Bundesausschuss (2013) Dossier zur Nutzenbewertung gemäß §35a SGB V: Behandlung des metastasierten kastrationsresistenten Prostatakarzinoms (mCRPC) bei erwachsenen Männern, deren Erkrankung während oder nach Docetaxel-haltiger Chemotherapie progredient ist. GB, Berlin

  2. Angelergues A, Maillet D, Flechon A et al (2013) Prognostic factors of survival in patients with metastatic castration resistant prostate cancer (mCRPC) treated with cabazitaxel: sequencing might matter. J Clin Oncol 31:2

    Google Scholar 

  3. Angelergues A, Maillet D, Flechon A et al (2014) Duration of response to androgen-deprivation therapy (ADT) and efficacy of secondary hormone therapy, docetaxel (D), and cabazitaxel (C) in metastatic castration-resistant prostate cancer (mCRPC). J Clin Oncol 32:1

    Article  Google Scholar 

  4. Azad A, Lester R, Heng DYC et al (2014) Impact of prior response to abiraterone acetate (AA) on subsequent activity of docetaxel (D) in metastatic castration-resistant prostate cancer (mCRPC) patients (pts). J Clin Oncol 32:1

    Article  Google Scholar 

  5. Azad AA, Eigl BJ, Murray RN et al (2015) Efficacy of enzalutamide following abiraterone acetate in chemotherapy-naive metastatic castration-resistant prostate cancer patients. Eur Urol 67:23–29

    Article  CAS  PubMed  Google Scholar 

  6. Azad AA, Leibowitz-Amit R, Eigl BJ et al (2014) A retrospective, Canadian multi-center study examining the impact of prior response to abiraterone acetate on efficacy of docetaxel in metastatic castration-resistant prostate cancer. Prostate 74:1544–1550

    Article  CAS  PubMed  Google Scholar 

  7. Berthold DR, Pond GR, Soban F et al (2008) Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer: updated survival in the TAX 327 study. J Clin Oncol 26:242–245

    Article  CAS  PubMed  Google Scholar 

  8. De Bono JS, Oudard S, Ozguroglu M et al (2010) Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet 376:1147–1154

    Article  Google Scholar 

  9. Fizazi K, Scher HI, Molina A et al (2012) Abiraterone acetate for treatment of metastatic castration-resistant prostate cancer: final overall survival analysis of the COU-AA-301 randomised, double-blind, placebo-controlled phase 3 study. Lancet Oncol 13:983–992

    Article  CAS  PubMed  Google Scholar 

  10. Gravis G, Fizazi K, Joly F et al (2013) Androgen-deprivation therapy alone or with docetaxel in non-castrate metastatic prostate cancer (GETUG-AFU 15): a randomised, open-label, phase 3 trial. Lancet Oncol 14:149–158

    Article  CAS  PubMed  Google Scholar 

  11. Huillard O, Albiges L, Eymard JC et al (2013) Efficacy of docetaxel chemotherapy in metastatic prostate cancer (mPC) patients (pts) experiencing early castration resistance (CR). J Clin Oncol 31:1

    Article  Google Scholar 

  12. Loriot Y, Massard C, Albiges L et al (2012) Personalizing treatment in patients with castrate-resistant prostate cancer: a study of predictive factors for secondary endocrine therapies activity. J Clin Oncol 30:1

    Article  Google Scholar 

  13. Mezynski J, Pezaro C, Bianchini D et al (2012) Antitumour activity of docetaxel following treatment with the CYP17A1 inhibitor abiraterone: clinical evidence for cross-resistance? Ann Oncol 23:2943–2947

    Article  CAS  PubMed  Google Scholar 

  14. Oudard S (2011) TROPIC: phase III trial of cabazitaxel for the treatment of metastatic castration-resistant prostate cancer. Future Oncol 7:497–506

    Article  CAS  PubMed  Google Scholar 

  15. Oudard S, Banu E, Scotte F et al (2007) Prostate-specific antigen doubling time before onset of chemotherapy as a predictor of survival for hormone-refractory prostate cancer patients. Ann Oncol 18:1828–1833

    Article  CAS  PubMed  Google Scholar 

  16. Oudard S, De Bono JS, Ozguroglu M et al (2012) Impact of cabazitaxel (CBZ) plus prednisone (P; CBZP) on overall survival (OS) at 2 yrs and in patientS (PTS) with aggressive disease: post-hoc analyses of TROPIC trial. Ann Oncol 23:307–308

    Google Scholar 

  17. Oudard S, Mercier F, Flechon A et al (2013) Efficacy of cabazitaxel and its relationship with predictors of poor response to second hormonal therapies (2d HT) in metastatic castration-resistant prostate cancer (mCRPC). J Clin Oncol 31:1

    Article  Google Scholar 

  18. Oudard SM, De Bono JS, Ozguroglu M et al (2010) Cabazitaxel plus prednisone/prednisolone significantly increases overall survival compared to mitoxantrone plus prednisone/prednisolone in patients with metastatic castration-resistant prostate cancer (mcrpc) previously treated with docetaxel: final results with updated overall survival of a multinational phase III triaL (TROPIC). Ann Oncol 21:272–272

    Google Scholar 

  19. Ryan CJ, Smith MR, De Bono JS et al (2013) Abiraterone in metastatic prostate cancer without previous chemotherapy. N Engl J Med 368:138–148

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Sartor AO, Oudard S, Ozguroglu M et al (2011) Survival benefit from first docetaxel treatment for cabazitaxel plus prednisone compared with mitoxantrone plus prednisone in patients with metastatic castration-resistant prostate cancer (mCRPC) enrolled in the TROPIC trial. J Clin Oncol 29:1

    Article  Google Scholar 

  21. Scher HI, Fizazi K, Saad F et al (2012) Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med 367:1187–1197

    Article  CAS  PubMed  Google Scholar 

  22. Schnadig ID, Bhor M, Vogelzang NJ et al (2013) Sequencing of cabazitaxel and abiraterone acetate following docetaxel in metastatic castration-resistant prostate cancer (mCRPC). J Clin Oncol 31:1

    Article  Google Scholar 

  23. Schweizer MT, Zhou XC, Wang H et al (2014) The influence of prior abiraterone treatment on the clinical activity of docetaxel in men with metastatic castration-resistant prostate cancer. Eur Urol 66:646–652

    Article  CAS  PubMed  Google Scholar 

  24. Sonpavde G, Bhor M, Hennessy D et al (2013) Outcomes with different sequences of cabazitaxel and abiraterone acetate following dooetaxel in metastatic castration-resistant prostate cancer (mCRPC). Eur J Cancer 49:S698–S698

    Google Scholar 

  25. Sweeney C, Chen Y, Carducci MA et al (2014) Impact on overall survival (OS) with chemohormonal therapy versus hormonal therapy for hormone-sensitive newly metastatic prostate cancer (mPrCa): an ECOG-led phase III randomized trial. J Clin Oncol 32:5s (suppl; abstr LBA2)

    Article  Google Scholar 

  26. Tannock IF, De Wit R, Berry WR et al (2004) Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 351:1502–1512

    Article  CAS  PubMed  Google Scholar 

  27. Tannock IF, Fizazi K, Ivanov S et al (2013) Aflibercept versus placebo in combination with docetaxel and prednisone for treatment of men with metastatic castration-resistant prostate cancer (VENICE): a phase 3, double-blind randomised trial. Lancet Oncol 14:760–768

    Article  CAS  PubMed  Google Scholar 

  28. Van Soest RJ, De Morree ES, Shen L et al (2014) Initial biopsy Gleason score as a predictive marker for survival benefit in patients with castration-resistant prostate cancer treated with docetaxel: data from the TAX327 study. Eur Urol 66:330–336

    Article  Google Scholar 

  29. Antonarakis ES, Lu C, Wang H et al. (2014) AR-V7 and resistance to enzalutamide and abiraterone in prostate cancer. N Engl J Med 371:1028-1038

    Article  PubMed Central  PubMed  Google Scholar 

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Appendix

Das Positionspapier basiert auf einem Expertenmeeting, das von der Firma Sanofi finanziert und organisiert wurde. Die Firma hatte keinen Einfluss auf die Inhalte des Manuskriptes. Für die redaktionelle Unterstützung bei der Manuskripterstellung danken wir Frau Birgit-Kristin Pohlmann, Nordkirchen.

Einhaltung ethischer Richtlinien

Interessenkonflikt. C.-H. Ohlmann, S. Duensing, R. Eichenauer, F. König, S. Machtens, M. Schostak, C. Thomas und P. Albers geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Kirrbergerstraße 1, 66424, Homburg, Deutschland

    C.-H. Ohlmann

  2. Sektion Molekulare Uroonkologie, Urologische Universitätsklinik Heidelberg, Heidelberg, Deutschland

    S. Duensing

  3. Ortsübergreifende Gemeinschaftspraxis, Urologikum Hamburg, Hamburg, Deutschland

    R. Eichenauer

  4. ATURO, Praxis für Urologie, Berlin, Deutschland

    F. König

  5. Klinik für Urologie und Kinderurologie, Marien-Krankenhaus gGmbH Bergisch Gladbach, Bergisch Gladbach, Deutschland

    S. Machtens

  6. Klinik für Urologie und Kinderurologie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Deutschland

    M. Schostak

  7. Urologische Klinik und Poliklinik, Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland

    C. Thomas

  8. Urologischen Klinik und Poliklinik, Universität Düsseldorf, Düsseldorf, Deutschland

    P. Albers

Authors
  1. C.-H. Ohlmann
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  2. S. Duensing
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  3. R. Eichenauer
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  4. F. König
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  5. S. Machtens
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  6. M. Schostak
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  7. C. Thomas
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  8. P. Albers
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Correspondence to C.-H. Ohlmann.

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Ohlmann, CH., Duensing, S., Eichenauer, R. et al. Metastasiertes Prostatakarzinom. Urologe 54, 998–1001 (2015). https://doi.org/10.1007/s00120-015-3841-0

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  • DOI: https://doi.org/10.1007/s00120-015-3841-0

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