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Therapie des metastasierten Prostatakarzinoms im Wandel – neue Daten und offene Fragen

Changes in the treatment of metastatic prostate cancer—new data and open questions

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Zusammenfassung

Die Taxan-basierte Chemotherapie und die gegen den Androgenrezeptor gerichteten Substanzen („androgen receptor-targeted agent“, ARTA) haben die therapeutischen Möglichkeiten beim metastasierten Prostatakarzinom (mPC) deutlich erweitert und bieten den Patienten die Chance, länger zu überleben. Die Therapiesequenz von ARTA und Taxanen kann Einfluss auf die Prognose haben und muss individuell entschieden werden. Ziel der vorliegenden Publikation ist es, eine Orientierungshilfe für den klinischen Alltag zu geben und Kriterien zu erarbeiten, die bei der individuellen Therapieentscheidung berücksichtigt werden können. Im Fokus stehen das metastasierte hormonnaive PC, die Behandlung oligometastasierter Patienten sowie das nichtmetastasierte und das metastasierte kastrationsresistente PC.

Abstract

The availability of taxane-based chemotherapy and androgen-receptor-targeted agents (ARTAs) have significantly broadened the therapeutic options for patients with metastatic prostate cancer and may also result in longer patient survival. The therapeutic sequence of ARTAs and taxanes may influence outcome and therefore decisions should be made on an individual basis. This article provides guidance for therapeutic decision-making in daily clinical practice by working out criteria that can be used to support individual therapeutic decisions. The focus is on metastatic castration-naive prostate cancer, oligometastatic disease as well as non-metastatic and metastatic castration-resistant prostate cancer.

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Authors and Affiliations

  1. Klinik für Urologie und Universitätstumorzentrum, Comprehensive Cancer Center, Universitätsklinikum, Medizinische Fakultät Heinrich-Heine-Universität, Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland

    P. Albers

  2. Klinik für Urologie und Kinderurologie, Universitätsklinikum Münster, Münster, Deutschland

    M. Bögemann

  3. Klinik für Urologie und Kinderurologie, GFO Kliniken Rhein Berg, Betriebsstätte, Marien-Krankenhaus, Bergisch Gladbach, Deutschland

    S. Machtens

  4. Klinik für Urologie, Campus Lübeck, Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland

    A. S. Merseburger

  5. Klinik für Urologie und Kinderurologie, Universitätsklinik Magdeburg, Magdeburg, Deutschland

    M. Schostak

  6. Martini-Klinik, Prostatakrebszentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    T. Steuber

  7. Abteilung für Urologie, Asklepios Klinik Altona, Hamburg, Deutschland

    C. Wülfing

  8. Klinik für Urologie, Interdisziplinäre Uro-Onkologie, Charité – Universitätsmedizin Berlin, Berlin, Deutschland

    M. De Santis

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  1. P. Albers
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Correspondence to P. Albers.

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Interessenkonflikt

P. Albers: Sanofi, MSD, Roche. M. Bögemann: Sanofi, Janssen, Astellas, Bayer, Abx. M. Schostak: Forschungsförderung durch MSD, BMS, Astra Zeneca, Sanofi, Roche, Novartis, Janssen, Reisekostenerstattungen durch MSD, BMS, Astra Zeneca, Sanofi, Roche, Novartis, Janssen, Berater: EDAP-TMS. C. Wülfing: Teilnehmer und Referent bei diversen Advisory Boards zum Prostatakarzinom, Sanofi, Janssen, Astellas. M. De Santis: Honorare: Amgen, Astellas, AstraZeneca, Basilea, Bayer, Bioclin, BMS, EISAI, ESSA, Ferring, Ipsen, Janssen, MSD, Merck, Novartis, Orion, Pfizer, Pierre Fabre Oncology, Roche, Sandoz, Sanofi, SeaGen, Takeda; Beratertätigkeit Amgen, Astellas, AstraZeneca, Basilea, Bayer, Bioclin, BMS, EISAI, ESSA, Ferring, Ipsen, Janssen, MSD, Merck, Novartis, Orion, Pfizer, Pierre Fabre Oncology, Roche, Sandoz, Sanofi, SeaGen, Takeda. S. Machtens, A.S. Merseburger und T. Steuber geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Albers, P., Bögemann, M., Machtens, S. et al. Therapie des metastasierten Prostatakarzinoms im Wandel – neue Daten und offene Fragen. Urologe 59, 307–317 (2020). https://doi.org/10.1007/s00120-019-01072-0

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