Skip to main content
Erschienen in: Der Urologe 3/2012

01.03.2012 | Übersichten

Zweitlinientherapie beim kastrationsresistenten Prostatakarzinom (CRPC)

verfasst von: B. Molitor, C. Börgermann

Erschienen in: Die Urologie | Ausgabe 3/2012

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Walczak JR, Carducci MA (2007) Prostate Cancer: a practical approach to current management of recurrent disease. Mayo Clin Proc 82:243–249PubMed Walczak JR, Carducci MA (2007) Prostate Cancer: a practical approach to current management of recurrent disease. Mayo Clin Proc 82:243–249PubMed
2.
Zurück zum Zitat Mottet N et al (2011) EAU Guidelines on Prostate Cancer, part II: treatment of advanced, relapsing and castration-resistant prostate cancer. Eur Urol 35(10):565–579 Mottet N et al (2011) EAU Guidelines on Prostate Cancer, part II: treatment of advanced, relapsing and castration-resistant prostate cancer. Eur Urol 35(10):565–579
3.
Zurück zum Zitat Lam JS, Leppert JT, Vemulapalli SN et al (2006) Secondary hormonal therapy for advanced prostate cancer. J Urol 175:27–34PubMedCrossRef Lam JS, Leppert JT, Vemulapalli SN et al (2006) Secondary hormonal therapy for advanced prostate cancer. J Urol 175:27–34PubMedCrossRef
4.
Zurück zum Zitat Schroder FH (2008) Progress in understanding androgen-indeoendent prostata cancer (AIPC): a review of potential endocrine-mediated mechanisms. Eur Urol 53(6):1129–1137PubMedCrossRef Schroder FH (2008) Progress in understanding androgen-indeoendent prostata cancer (AIPC): a review of potential endocrine-mediated mechanisms. Eur Urol 53(6):1129–1137PubMedCrossRef
5.
Zurück zum Zitat Attard G, Reid AH, A’Hern R et al (2009) Selective inhibition of CYP17 with abiraterone acetate is highly active in the treatment of castration-resistant prostate cancer. J Clin Oncol 27:3742–3748PubMedCrossRef Attard G, Reid AH, A’Hern R et al (2009) Selective inhibition of CYP17 with abiraterone acetate is highly active in the treatment of castration-resistant prostate cancer. J Clin Oncol 27:3742–3748PubMedCrossRef
6.
Zurück zum Zitat Edwards J, Bartlett JM (2005) The androgen receptor and signal-transduction pathways in hormone-refractory prostate cancer, part 1: Modifications to the androgen receptor. BJU Int 95:1320–1326PubMedCrossRef Edwards J, Bartlett JM (2005) The androgen receptor and signal-transduction pathways in hormone-refractory prostate cancer, part 1: Modifications to the androgen receptor. BJU Int 95:1320–1326PubMedCrossRef
7.
Zurück zum Zitat Edwards J, Bartlett JM (2005) The androgen receptor and signal-transduction pathways in hormone-refractory prostate cancer, part 2: Androgen-receptor cofactors and bypass pathways. BJU Int 95:1327–1335PubMedCrossRef Edwards J, Bartlett JM (2005) The androgen receptor and signal-transduction pathways in hormone-refractory prostate cancer, part 2: Androgen-receptor cofactors and bypass pathways. BJU Int 95:1327–1335PubMedCrossRef
8.
Zurück zum Zitat Edwards J, Krishna NS, Grigor KM, Bartlett JM (2003) Androgen receptor gene amplification and protein expression in hormone refractory prostate cancer. Br J Cancer 89:552–556PubMedCrossRef Edwards J, Krishna NS, Grigor KM, Bartlett JM (2003) Androgen receptor gene amplification and protein expression in hormone refractory prostate cancer. Br J Cancer 89:552–556PubMedCrossRef
9.
Zurück zum Zitat Tannock IF, Wit R de, Berry WR et al (2004) TAX 327 Investigators. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 351:1502–1512PubMedCrossRef Tannock IF, Wit R de, Berry WR et al (2004) TAX 327 Investigators. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 351:1502–1512PubMedCrossRef
10.
Zurück zum Zitat 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 351:1513–1520PubMedCrossRef 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 351:1513–1520PubMedCrossRef
11.
Zurück zum Zitat Ansari J, Hussain SA, Zarkar A et al (2008) Docetaxel chemotherapy for metastatic hormone refractory prostate cancer as first-line palliative chemotherapy and subsequent re-treatment: Birmingham experience. Oncol Rep 20:891–896PubMed Ansari J, Hussain SA, Zarkar A et al (2008) Docetaxel chemotherapy for metastatic hormone refractory prostate cancer as first-line palliative chemotherapy and subsequent re-treatment: Birmingham experience. Oncol Rep 20:891–896PubMed
12.
Zurück zum Zitat Eymard JC, Oudard S, Gravis G et al (2010) Docetaxel reintroduction in patients with metastatic castration-resistant docetaxel-sensitive prostate cancer: a retrospective multicentre study. BJU Int 106:974–978PubMedCrossRef Eymard JC, Oudard S, Gravis G et al (2010) Docetaxel reintroduction in patients with metastatic castration-resistant docetaxel-sensitive prostate cancer: a retrospective multicentre study. BJU Int 106:974–978PubMedCrossRef
13.
Zurück zum Zitat De Bono JS, Oudard S, Ozguroglu M et al (2010) TROPIC Investigators. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet 376:1147–1154CrossRef De Bono JS, Oudard S, Ozguroglu M et al (2010) TROPIC Investigators. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet 376:1147–1154CrossRef
14.
Zurück zum Zitat Aller AW, Kraus LA, Bissery M-C (2000) In vitro activity of TXD258 in chemotherapeutic resistant tumor cell lines. Proc Am Assoc Cancer Res 41:303 Aller AW, Kraus LA, Bissery M-C (2000) In vitro activity of TXD258 in chemotherapeutic resistant tumor cell lines. Proc Am Assoc Cancer Res 41:303
15.
Zurück zum Zitat Bissery MC, Bouchard H, Riou JF et al (2000) Preclinical evaluation of TXD258, a new taxoid. Proc Am Assoc Cancer Res 41:214 Bissery MC, Bouchard H, Riou JF et al (2000) Preclinical evaluation of TXD258, a new taxoid. Proc Am Assoc Cancer Res 41:214
16.
Zurück zum Zitat Sternberg CN, Petrylak DP, Sartor O et al (2009) Multinational, double-blind, phase III study of prednisone and either satraplatin or placebo in patients with castrate-refractory prostate cancer progressing after prior chemotherapy: the SPARC trial. J Clin Oncol 27:5431–5438PubMedCrossRef Sternberg CN, Petrylak DP, Sartor O et al (2009) Multinational, double-blind, phase III study of prednisone and either satraplatin or placebo in patients with castrate-refractory prostate cancer progressing after prior chemotherapy: the SPARC trial. J Clin Oncol 27:5431–5438PubMedCrossRef
17.
Zurück zum Zitat Reuter CW, Morgan MA, Ivanyi P et al (2010) Carboplatin plus weekly docetaxel as salvage chemotherapy in docetaxel-resistant and castration-resistant prostata cancer. World J Urol 28:391–398PubMedCrossRef Reuter CW, Morgan MA, Ivanyi P et al (2010) Carboplatin plus weekly docetaxel as salvage chemotherapy in docetaxel-resistant and castration-resistant prostata cancer. World J Urol 28:391–398PubMedCrossRef
18.
Zurück zum Zitat Tannock IF, Osoba D, Stockler MR et al (1996) Chemotherapy with mitoxantrone plus prednisone or prednisone alone for symptomatic hormone-resistant prostate cancer: a Canadian randomized trial with palliative end points. J Clin Oncol 14:1756–1764PubMed Tannock IF, Osoba D, Stockler MR et al (1996) Chemotherapy with mitoxantrone plus prednisone or prednisone alone for symptomatic hormone-resistant prostate cancer: a Canadian randomized trial with palliative end points. J Clin Oncol 14:1756–1764PubMed
19.
Zurück zum Zitat Galsky MD, Vogelzang NJ (2010) Docetaxel-based combination therapy for castration-resistant prostate cancer. Ann Oncol 21:2135–2144PubMedCrossRef Galsky MD, Vogelzang NJ (2010) Docetaxel-based combination therapy for castration-resistant prostate cancer. Ann Oncol 21:2135–2144PubMedCrossRef
20.
Zurück zum Zitat Ning YM, Gulley JL, Arlen PM et al (2010) Phase II trial of bevacizumab, thalidomide, docetaxel, and prednisone in patients with metastatic castration-resistant prostate cancer. J Clin Oncol 28:2070–2076PubMedCrossRef Ning YM, Gulley JL, Arlen PM et al (2010) Phase II trial of bevacizumab, thalidomide, docetaxel, and prednisone in patients with metastatic castration-resistant prostate cancer. J Clin Oncol 28:2070–2076PubMedCrossRef
21.
Zurück zum Zitat Vishnu P, Tan WW (2010) Update on options for treatment of metastatic castration-resistant prostate cancer. Onco Targets Ther 3:39–51PubMed Vishnu P, Tan WW (2010) Update on options for treatment of metastatic castration-resistant prostate cancer. Onco Targets Ther 3:39–51PubMed
22.
Zurück zum Zitat Higano CS, Schellhammer PF, Small EJ et al (2009) Integrated data from 2 randomized, double-blind, placebo-controlled, phase 3 trials of active cellular immunotherapy with sipuleucel-T in advanced prostate cancer. Cancer 115:3670–3679PubMedCrossRef Higano CS, Schellhammer PF, Small EJ et al (2009) Integrated data from 2 randomized, double-blind, placebo-controlled, phase 3 trials of active cellular immunotherapy with sipuleucel-T in advanced prostate cancer. Cancer 115:3670–3679PubMedCrossRef
23.
Zurück zum Zitat Kantoff PW, Higano CS, Shore ND et al (2010) IMPACT Study Investigators. Sipuleucel-T immunotherapy for castration-resistant prostate cancer. N Engl J Med 363:411–422PubMedCrossRef Kantoff PW, Higano CS, Shore ND et al (2010) IMPACT Study Investigators. Sipuleucel-T immunotherapy for castration-resistant prostate cancer. N Engl J Med 363:411–422PubMedCrossRef
24.
Zurück zum Zitat Higano CS, Corman JM, Smith DC et al (2008) Phase 1/2 dose-escalation study of a GM-CSF-secreting, allogeneic, cellular immunotherapy for metastatic hormone-refractory prostate cancer. Cancer 113:975–984PubMedCrossRef Higano CS, Corman JM, Smith DC et al (2008) Phase 1/2 dose-escalation study of a GM-CSF-secreting, allogeneic, cellular immunotherapy for metastatic hormone-refractory prostate cancer. Cancer 113:975–984PubMedCrossRef
25.
Zurück zum Zitat Cha E, Fong L (2010) Therapeutic vaccines for prostate cancer. Curr Opin Mol Ther 12:77–85PubMed Cha E, Fong L (2010) Therapeutic vaccines for prostate cancer. Curr Opin Mol Ther 12:77–85PubMed
26.
Zurück zum Zitat Kantoff PW, Schuetz TJ, Blumenstein BA et al (2010) Overall survival analysis of a phase II randomized controlled trial of a Poxviral-based PSA-targeted immunotherapy in metastatic castration-resistant prostate cancer. J Clin Oncol 28:1099–1105PubMedCrossRef Kantoff PW, Schuetz TJ, Blumenstein BA et al (2010) Overall survival analysis of a phase II randomized controlled trial of a Poxviral-based PSA-targeted immunotherapy in metastatic castration-resistant prostate cancer. J Clin Oncol 28:1099–1105PubMedCrossRef
27.
Zurück zum Zitat Attard G, Reid AH, A’Hern R et al (2009) Selective inhibition of CYP17 with abiraterone acetate is highly active in the treatment of castration-resistant prostate cancer. J Clin Oncol 27:3742–3748PubMedCrossRef Attard G, Reid AH, A’Hern R et al (2009) Selective inhibition of CYP17 with abiraterone acetate is highly active in the treatment of castration-resistant prostate cancer. J Clin Oncol 27:3742–3748PubMedCrossRef
28.
Zurück zum Zitat De Bono JS, Logothetis CJ, Fizazi K et al (2010) Abiraterone acetate (AA) plus low dose prednisone (P) improves overall survival in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) who have progressed after docetaxel-based chemotherapy (chemo): Results of COU-AA-301. Presidential symposium at ESMO, Milan, Italy De Bono JS, Logothetis CJ, Fizazi K et al (2010) Abiraterone acetate (AA) plus low dose prednisone (P) improves overall survival in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) who have progressed after docetaxel-based chemotherapy (chemo): Results of COU-AA-301. Presidential symposium at ESMO, Milan, Italy
29.
Zurück zum Zitat Tran C, Ouk S, Clegg NJ et al (2009) Development of a second-generation antiandrogen for treatment of advanced prostate cancer. Science 324:787–790PubMedCrossRef Tran C, Ouk S, Clegg NJ et al (2009) Development of a second-generation antiandrogen for treatment of advanced prostate cancer. Science 324:787–790PubMedCrossRef
30.
Zurück zum Zitat Scher HI, Beer TM, Higano CS et al (2010) Antitumour activity of MDV3100 in castration-resistant prostate cancer: a phase 1–2 study. Lancet 375:1437–1446PubMedCrossRef Scher HI, Beer TM, Higano CS et al (2010) Antitumour activity of MDV3100 in castration-resistant prostate cancer: a phase 1–2 study. Lancet 375:1437–1446PubMedCrossRef
31.
Zurück zum Zitat Eichenberger T, Trachtenberg J, Chronis P, Keating A (1989) Synergistic effect of ketoconazole and antineoplastic agents on hormone-independent prostatic cancer cells. Clin Invest Med 12(6):363–366PubMed Eichenberger T, Trachtenberg J, Chronis P, Keating A (1989) Synergistic effect of ketoconazole and antineoplastic agents on hormone-independent prostatic cancer cells. Clin Invest Med 12(6):363–366PubMed
32.
Zurück zum Zitat Small EJ, Halabi S, Dawson NA et al (2004) Antiandrogen withdrawal alone or in combination with ketoconazole in androgen-independent prostate cancer patients: a phase III trial (CALGB 9583). J Clin Oncol 22:1025–1033PubMedCrossRef Small EJ, Halabi S, Dawson NA et al (2004) Antiandrogen withdrawal alone or in combination with ketoconazole in androgen-independent prostate cancer patients: a phase III trial (CALGB 9583). J Clin Oncol 22:1025–1033PubMedCrossRef
33.
Zurück zum Zitat Petrylak DP, Macarthur R, O’Connor J et al (1999) Phase I/II studies of docetaxel (Taxotere) combined with estramustine in men with hormone-refractory prostate cancer. Semin Oncol 26:28–33PubMed Petrylak DP, Macarthur R, O’Connor J et al (1999) Phase I/II studies of docetaxel (Taxotere) combined with estramustine in men with hormone-refractory prostate cancer. Semin Oncol 26:28–33PubMed
34.
Zurück zum Zitat 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 351:1513–1520PubMedCrossRef 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 351:1513–1520PubMedCrossRef
35.
Zurück zum Zitat Warren R, Liu G (2008) ZD4054: a specific endothelin A receptor antagonist with promising activity in metastatic castration-resistant prostate cancer. Expert Opin Investig Drugs 17:1237–1245PubMedCrossRef Warren R, Liu G (2008) ZD4054: a specific endothelin A receptor antagonist with promising activity in metastatic castration-resistant prostate cancer. Expert Opin Investig Drugs 17:1237–1245PubMedCrossRef
36.
Zurück zum Zitat James ND, Caty A, Borre M et al (2009) Safety and efficacy of the specific endothelin-A receptor antagonist ZD4054 in patients with hormone-resistant prostate cancer and bone metastases who were pain free or mildly symptomatic: a double-blind, placebo-controlled, randomised, phase 2 trial. Eur Urol 55:1112–1123PubMedCrossRef James ND, Caty A, Borre M et al (2009) Safety and efficacy of the specific endothelin-A receptor antagonist ZD4054 in patients with hormone-resistant prostate cancer and bone metastases who were pain free or mildly symptomatic: a double-blind, placebo-controlled, randomised, phase 2 trial. Eur Urol 55:1112–1123PubMedCrossRef
37.
Zurück zum Zitat James ND, Caty A, Payne H et al (2010) Final safety and efficacy analysis of the specific endothelin A receptor antagonist zibotentan (ZD4054) in patients with metastatic castration-resistant prostate cancer and bone metastases who were pain-free or mildly symptomatic for pain: a double-blind, placebo-controlled, randomized phase II trial. BJU Int 106:966–973PubMedCrossRef James ND, Caty A, Payne H et al (2010) Final safety and efficacy analysis of the specific endothelin A receptor antagonist zibotentan (ZD4054) in patients with metastatic castration-resistant prostate cancer and bone metastases who were pain-free or mildly symptomatic for pain: a double-blind, placebo-controlled, randomized phase II trial. BJU Int 106:966–973PubMedCrossRef
38.
Zurück zum Zitat Shepard DR, Dreicer R (2010) Zibotentan for the treatment of castrate-resistant prostate cancer. Expert Opin Investig Drugs 19:899–908PubMedCrossRef Shepard DR, Dreicer R (2010) Zibotentan for the treatment of castrate-resistant prostate cancer. Expert Opin Investig Drugs 19:899–908PubMedCrossRef
39.
Zurück zum Zitat Armstrong AJ, Febbo PG (2009) Using surrogate biomarkers to predict clinical benefit in men with castration-resistant prostate cancer: an update and review of the literature. Oncologist 14:816–827PubMed Armstrong AJ, Febbo PG (2009) Using surrogate biomarkers to predict clinical benefit in men with castration-resistant prostate cancer: an update and review of the literature. Oncologist 14:816–827PubMed
Metadaten
Titel
Zweitlinientherapie beim kastrationsresistenten Prostatakarzinom (CRPC)
verfasst von
B. Molitor
C. Börgermann
Publikationsdatum
01.03.2012
Verlag
Springer-Verlag
Erschienen in
Die Urologie / Ausgabe 3/2012
Print ISSN: 2731-7064
Elektronische ISSN: 2731-7072
DOI
https://doi.org/10.1007/s00120-011-2758-5

Weitere Artikel der Ausgabe 3/2012

Der Urologe 3/2012 Zur Ausgabe

Mitteilungen der DGU

Termine

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

Stufenschema weist Prostatakarzinom zuverlässig nach

22.04.2024 Prostatakarzinom Nachrichten

Erst PSA-Test, dann Kallikrein-Score, schließlich MRT und Biopsie – ein vierstufiges Screening-Schema kann die Zahl der unnötigen Prostatabiopsien erheblich reduzieren: Die Hälfte der Männer, die in einer finnischen Studie eine Biopsie benötigten, hatte einen hochgradigen Tumor.

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

20.04.2024 EAU 2024 Kongressbericht

Beim chronischen Harnwegsinfekt bei Frauen wird bisher meist eine Antibiotikaprophylaxe eingesetzt. Angesichts der zunehmenden Antibiotikaresistenz erweist sich das Antiseptikum Methenamin-Hippurat als vielversprechende Alternative, so die Auswertung einer randomisierten kontrollierten Studie.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.