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Aktuelle Urol 2019; 50(05): 509-512
DOI: 10.1055/a-0972-0824
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Personalisierte Medizin beim Prostatakarzinom

Personalised medicine in prostate cancer
David Pfister
1   Universitätsklinikum Köln, Urologie, Köln
,
Friederike Haidl
2   Universitätsklinikum Köln, Urologie, Uro-Onkologie, spezielle urologische und Roboter-assistierte Chirurgie, Köln
,
Pia Paffenholz
1   Universitätsklinikum Köln, Urologie, Köln
,
Tim Nestler
1   Universitätsklinikum Köln, Urologie, Köln
,
Axel Heidenreich
1   Universitätsklinikum Köln, Urologie, Köln
› Author Affiliations
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Publication History

Publication Date:
29 August 2019 (online)

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Zusammenfassung

Das Prostatakarzinom ist das häufigste solide Karzinom des Mannes. Die Inzidenz steigt mit zunehmendem Alter an. Durch die Etablierung neuer Therapiekonzepte insbesondere im progredienten Tumorstadium und in der metastasierten Erkrankung kann zum einen eine deutlich verbesserte Tumorkontrolle, damit verbunden aber auch eine erhöhte Belastung des Gesundheitssystems erreicht werden. Mittlerweile haben wir beim Prostatakarzinom, ähnlich wie beim Nierenzellkarzinom, die Möglichkeit aus einem Pool von verschiedenen Medikamenten zu wählen. Diese zeigen eine vergleichbare Effektivität bei einem unterschiedlichen Nebenwirkungsspektrum. Zur effektiven Diagnostik und Therapie des Prostatakarzinoms sind neben klinischen Parametern weitere Faktoren erforderlich, um ein individualisiertes Vorgehen zu erlauben. In der Diagnostik haben sich einige genetische Tests etabliert, während im metastasierten Tumorstadium eine intensivere genetische Aufarbeitung von liquid biopsies oder Gewebeproben zunehmend in der Routine Einklang findet. Möglichkeiten im kastrationsresistenten Prostatakarzinom mit der möglichen Patientenselektion zur individuellen Therapie sollen im folgenden Review aufgearbeitet werden.

Abstract

Prostate cancer is the most common cancer in men. Its incidence increases with age. New treatment options have been introduced and there is a clear trend to more aggressive treatment in newly diagnosed metastatic disease. While prolonged survival of patients has been achieved, the new expensive drugs are associated with an increased burden on the healthcare system. Meanwhile, similarly to other tumour entities, there is a pool of different drugs available with comparable oncologic efficacy, but different side-effects. Effective diagnostic investigation and treatment decisions require additional factors, above and beyond clinical parameters, for a more individual treatment approach. In castration-resistant prostate cancer (CRPCA), there are promising molecular markers for treatment decisions. In metastatic disease, liquid biopsies and next generation sequencing of metastatic biopsies allow for genetic analysis. These will provide more insight into tumour dynamics and allow for patient selection. This review concentrates on molecular markers in CRPCA.

Schlüsselwörter

Prostatakarzinom - Kastrationsresistenz - Mutation - next generation sequencing

Keywords

Prostate cancer - castration resistance - mutation - next generation sequencing
 

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