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DOI: 10.1055/a-1121-7400
Ziel: 20 statt 50! Aktuelle Daten zum Zielwert der Testosteronsenkung und die Forschung hierüber seit erster „LH-RH“ (GnRH)-Analoga-Gabe an Patienten vor 40 Jahren
Current data on the target value of testosterone lowering and the associated research since the first administration of LHRH (GnRH) analogues to patients 40 years agoZusammenfassung
Beim ersten Einsatz eines LH-RH (heute: GnRH)-Analogon zur Therapie des Prostatakarzinoms war das Kastrationsniveau von unter 50 ng/dl willkürlich festgelegt. Seither zeigen zahlreiche Untersuchungen, dass mit einer dauerhaften Senkung des Testosteronspiegels, wie z. B. durch Buserelin, auf Werte von unter 20 ng/dl eine deutliche Verbesserung des Outcome einhergeht. Dies wird in aktuellen Studien belegt, sodass der Kastrationsspiegel mit Werten von unter 20 ng/dl zu fordern ist. Darüber hinaus stellt der Hormonentzug mit GnRH-Analoga weiterhin die Basistherapie für neue Therapieoptionen wie z. B. mit Abirateron, Enzalutamid bzw. Apalutamid dar.
Abstract
When LH-RH (now: GNRH) analogues were first used for the treatment of prostate cancer, the castration level was arbitrarily defined as a testosterone level of less than 50 ng/dl. Since then, numerous studies have shown that a permanent lowering of the testosterone level, e. g. by buserelin, to values lower than 20 ng/dl is associated with a significant improvement in outcomes. This has been proven in recent studies. Therefore, a castration level with testosterone values of less than 20 ng/dl is required. In addition, hormone withdrawal with GNRH analogues continues to provide the basic therapy for new treatment options, e. g. with abiraterone, enzalutamide or apalutamide.
Publication History
Article published online:
18 March 2020
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