Skip to main content
SpringerLink
Log in

Chemotherapie des Prostatakarzinoms

Chemotherapy of prostate cancer

  • CME Zertifizierte Fortbildung
  • Published:
Der Urologe Aims and scope Submit manuscript

Zusammenfassung

Die Prognose des fortgeschrittenen Prostatakarzinoms hat sich in den letzten Jahren deutlich verbessert. Neben den neuen antihormonellen Therapien tragen dazu auch die Chemotherapien mit Docetaxel und Cabazitaxel bei. Nach Einführung von Abirateron und Enzalutamid schienen Chemotherapien beim Prostatakarzinom zunächst an Bedeutung zu verlieren. Doch hat die Diskussion um ihren Einsatz beim hormonsensitiven Prostatakarzinom diese Behandlungsoption wieder in den Vordergrund gerückt. Die kombinierte Anwendung von Chemo- und Androgendeprivationstherapie (ADT) führt zu einem deutlichen Überlebensvorteil gegenüber der alleinigen ADT. Docetaxel für die Erstlinientherapie und Cabazitaxel für die Zweitlinientherapie gehören inzwischen zum Standard in der Therapie des kastrationsresistenten Prostatakarzinoms.

Abstract

The prognosis of patients with advanced prostate cancer has improved over the last few years. In addition to the new antihormonal treatment, chemotherapy with agents such as docetaxel and cabazitaxel has contributed to the improved prognosis. After the introduction of abiraterone and enzalutamide, conventional chemotherapy seemed to become less important but the discussion about the use of chemotherapy for hormone-sensitive prostate cancer has gained attention again. Combining docetaxel with conventional androgen deprivation therapy (ADT) improves survival compared to ADT alone. In addition, docetaxel and cabazitaxel now represent the standard for first and second line therapy in patients with castration-resistant prostate cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Robert Koch-Institut, Gesellschaft der epidemiologischen Krebsregister in Deutschland e. V. (2013) Krebs in Deutschland 2009/2010. http://www.rki.de

  2. 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 

  3. Beer TM, Armstrong AJ, Rathkopf DE et al (2014) Enzalutamide in metastatic prostate cancer before chemotherapy. N Engl J Med 371:424–433

    Article  PubMed Central  PubMed  Google Scholar 

  4. Ryan CJ, Smith MR, Fizazi K et al (2015) Abiraterone acetate plus prednisone versus placebo plus prednisone in chemotherapy-naive men with metastatic castration-resistant prostate cancer (COU-AA-302): final overall survival analysis of a randomised, double-blind, placebo-controlled phase 3 study. Lancet Oncol 16:152–160

    Article  CAS  PubMed  Google Scholar 

  5. Halabi S, Lin CY, Kelly WK et al (2014) Updated prognostic model for predicting overall survival in first-line chemotherapy for patients with metastatic castration-resistant prostate cancer. J Clin Oncol 32:671–677

    Article  PubMed Central  PubMed  Google Scholar 

  6. Halabi S, Lin CY, Small EJ et al (2013) Prognostic model predicting metastatic castration-resistant prostate cancer survival in men treated with second-line chemotherapy. J Natl Cancer Inst 105:1729–1737

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. 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 

  8. Wang LG, Liu XM, Kreis W et al (1999) The effect of antimicrotubule agents on signal transduction pathways of apoptosis: a review. Cancer Chemother Pharmacol 44:355–361

    Article  CAS  PubMed  Google Scholar 

  9. Schiff PB, Horwitz SB (1980) Taxol stabilizes microtubules in mouse fibroblast cells. Proc Natl Acad Sci U S A 77:1561–1565

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Zhu ML, Horbinski CM, Garzotto M et al (2010) Tubulin-targeting chemotherapy impairs androgen receptor activity in prostate cancer. Cancer Res 70:7992–8002

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Deutsche Gesellschaft für Urologie e. V. (2014) Interdisziplinäre Leitlinie der Qualität S3 zur Früherkennung, Diagnose und Therapie der verschiedenen Stadien des Prostatakarzinoms. AWMF-Register-Nr. 043/022OL. http://www.awmf.org

  12. Heidenreich A, Bastian PJ, Bellmunt J et al (2014) EAU guidelines on prostate cancer. Part II: treatment of advanced, relapsing, and castration-resistant prostate cancer. Eur Urol 65:467–479

    Article  CAS  PubMed  Google Scholar 

  13. 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 

  14. James ND, Spears MR, Clarke NW et al (2015) Survival with newly diagnosed metastatic prostate cancer in the „Docetaxel Era“: data from 917 patients in the control arm of the STAMPEDE Trial (MRC PR08, CRUK/06/019). Eur Urol 67:1028–1038

    Article  PubMed  Google Scholar 

  15. 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 

  16. Gravis G, Boher JM, Joly F et al (2015) Androgen deprivation therapy (ADT) plus docetaxel (D) versus ADT alone for hormone-naïve metastatic prostate cancer (PCa): long-term analysis of the GETUG-AFU 15 phase III trial. J Clin Oncol 33 (Suppl 7):abstract 140

    Google Scholar 

  17. Gulley J, Dahut WL (2004) Chemotherapy for prostate cancer: finally an advance! Am J Ther 11:288–294

    Article  PubMed  Google Scholar 

  18. Petrylak DP, Tangen CM, Hussain MH et al (2004) Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer. N Engl J Med 351:1513–1520

    Article  CAS  PubMed  Google Scholar 

  19. Ohlmann CH, Duensing S, Eichenauer R et al (2015) Metastasized prostate cancer: position paper on the use of chemotherapy. Urologe A 54:998–1001

    Article  PubMed  Google Scholar 

  20. Kellokumpu-Lehtinen PL, Harmenberg U, Joensuu T et al (2013) 2-Weekly versus 3-weekly docetaxel to treat castration-resistant advanced prostate cancer: a randomised, phase 3 trial. Lancet Oncol 14:117–124

    Article  CAS  PubMed  Google Scholar 

  21. 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. https://www.g-ba.de

  22. 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 

  23. 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 

  24. 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  PubMed Central  CAS  PubMed  Google Scholar 

  25. 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 (Suppl):abstract 5063

    Google Scholar 

  26. 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 (Suppl):abstract 5075

    Google Scholar 

  27. 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 (Suppl 5):abstract 213

    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. 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 

  30. Brooks TA, Minderman H, O’Loughlin KL et al (2003) Taxane-based reversal agents modulate drug resistance mediated by P-glycoprotein, multidrug resistance protein, and breast cancer resistance protein. Mol Cancer Ther 2:1195–1205

    CAS  PubMed  Google Scholar 

  31. 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 

  32. Heidenreich A, Pfister D (2012) Treatment decisions for metastatic castration-resistant prostate cancer progressing after docetaxel chemotherapy: the role of cabazitaxel in the continuum of care. Eur Urol 62:1201–1204

    Article  PubMed  Google Scholar 

  33. 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 

  34. 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 

Download references

Einhaltung ethischer Richtlinien

Interessenkonflikt. C.-H. Ohlmann gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information

Authors and Affiliations

  1. Klinik für Urologie und Kinderurologie, Universität des Saarlandes, Kirrbergerstr., 66421, Homburg/Saar, Deutschland

    C.-H. Ohlmann

Authors
  1. C.-H. Ohlmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C.-H. Ohlmann.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ohlmann, CH. Chemotherapie des Prostatakarzinoms. Urologe 54, 1461–1470 (2015). https://doi.org/10.1007/s00120-015-3911-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00120-015-3911-3

Schlüsselwörter

Keywords

Search

Navigation