Aktuelle Urol 2019; 50(06): 625-628
DOI: 10.1055/a-0852-3405
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Abirateron plus Prednison beim neu diagnostizierten Hochrisiko-metastasierten hormonsensitiven Prostatakarzinom (mHSPC)

Abiraterone plus prednisone in patients with newly diagnosed high-risk metastatic hormone-sensitive prostate cancer (mHSPC)
Kurt Miller
Charité – Universitätsmedizin Berlin, Urologie, Berlin
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
27. März 2019 (online)

Zusammenfassung

Die Ergebnisse der beiden Studien LATITUDE [1] und STAMPEDE [2] zur Kombinationstherapie von Abirateron plus Prednison (Abirateron/P) mit konventioneller ADT haben eine praxisverändernde Alternative zur kombinierten Hormon-Chemotherapie mit ADT plus Docetaxel in der Erstlinientherapie des neu diagnostizierten Hochrisiko-metastasierten hormonsensitiven Prostatakarzinoms (mHSPC) aufgezeigt. In beiden Studien führte Abirateron/P zu einer deutlichen Verlängerung des progressionsfreien und Gesamtüberlebens. Ob Abirateron/P plus ADT als neuer Goldstandard beim neu diagnostizierten Hochrisiko-mHSPC anzusehen ist, kann derzeit nicht sicher beurteilt werden, da direkte Vergleichsstudien noch fehlen. Die vorliegenden indirekten Daten zeigen aber, dass Abirateron/P eine mindestens vergleichbare, wenn nicht sogar etwas höhere Effektivität aufweist, bei einer insgesamt besseren Verträglichkeit.

Abstract

The most exciting data presented at the 2017 ASCO Annual Meeting included the results of the LATITUDE and STAMPEDE trials, which evaluated abiraterone plus prednisone combined with androgen-deprivation therapy (ADT) as a first-line treatment in men with newly diagnosed high-risk metastatic hormone-sensitive prostate cancer (mHSPC), demonstrating a practice-changing alternative to chemo-hormonal treatment with docetaxel plus ADT. In both trials, the addition of abiraterone plus prednisone to ADT significantly prolonged both progression-free survival and overall survival. In the absence of head-to-head evidence, it remains unclear if abiraterone plus prednisone and ADT should be the new gold standard for patients with newly diagnosed high-risk mHSPC. However, the results of indirect comparisons demonstrate that abiraterone plus prednisone is similarly or even more effective compared with chemotherapy and better tolerated overall.

 
  • Literatur

  • 1 Fizazi M. et al. Abiraterone plus Prednisone in Metastatic, Castration-Sensitive Prostate Cancer. N Engl J Med 2017; 377: 352-360
  • 2 James ND. et al. Abiraterone for Prostate Cancer Not Previously Treated with Hormone Therapy. N Engl J Med 2017; 377: 338-351
  • 3 Sweeney CJ. et al. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer. N Engl J Med 2015; 373: 737-746
  • 4 James ND. et al. Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial. Lancet 2016; 387: 1163-1177
  • 5 S3-Leitlinie zur Früherkennung, Diagnose und Therapie der verschiedenen Stadien des Prostatakarzinoms. Version 5.0 – April 2018 AWMF-Registernummer: 043/022OL. Abrufbar unter: https://www.leitlinienprogramm-onkologie.de/leitlinien/prostatakarzinom/ , Letzter Zugriff am 17.09.2018
  • 6 Cornford P. et al. EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part II: Treatment of Relapsing, Metastatic, and Castration-Resistant Prostate Cancer. Eur Urol 2017; 71: 630-642
  • 7 Fizazi M. et al. Longer term preplanned efficacy and safety analysis of abiraterone acetate + prednisone (AA + P) in patients (pts) with newly diagnosed high-risk metastatic castration-naïve prostate cancer (NDx-HR mCNPC) from the phase 3 LATITUDE trial. J Clin Oncol 2018; 36 (Suppl. 15) 5023 (abstr)
  • 8 Fizazi M. et al. Abiraterone plus Prednisone in Metastatic, Castration-Sensitive Prostate Cancer. N Engl J Med 2017; 377: 352-360 (LATITUDE-Protokoll)
  • 9 Chi K. et al. Patient-reported outcomes following abiraterone acetate plus prednisone added to androgen deprivation therapy in patients with newly diagnosed metastatic castration-naive prostate cancer (LATITUDE): an international, randomised phase 3 trial. Lancet Oncol 2018; 19: 194-206
  • 10 Feyerabend S. et al. Indirect Comparison of Abiraterone Acetate and Docetaxel for Treatment of Metastatic Hormone-Sensitive Prostate Cancer. ESMO 2017; 28 (Suppl. 05) Abstr. 803P DOI: 10.1093/annonc/mdx370.020.
  • 11 Vale CL. et al. What is the optimal systemic treatment of men with metastatic, hormone-naive prostate cancer? A STOPCAP systematic review and network meta-analysis. Ann Oncol 2018; 29: 1249-1257
  • 12 Sydes MR. et al. Adding abiraterone acetate plus prednisolone (AAP) or docetaxel for patients (pts) with high-risk prostate cancer (PCa) starting long-term androgen deprivation therapy (ADT): directly randomised data from STAMPEDE. Ann Oncol 2018; 29: 1235-1248
  • 13 ESMO Guidelines Committee. eUpdate – Cancer of the Prostate Treatment Recommendations. 28.09.2017 URL: http://www.esmo.org/Guidelines/Genitourinary-Cancers/Cancer-of-the-Prostate/eUpdate-Treatment-Recommendation (Zugriff am 27.11.2017)
  • 14 Mottet N. et al. Updated Guidelines for Metastatic Hormone-sensitive Prostate Cancer: Abiraterone Acetate Combined with Castration Is Another Standard. Eur Urol 2017; DOI: 10.1016/j.eururo.2017.09.029. [Epub ahead of print]