Medikamentöse Tumortherapie des mHSPC: Double- oder Tripletherapie: wer, wann und wie?

Zusammenfassung

Die alleinige Androgendeprivation (ADT) zur Therapie des metastasierten hormonsensitiven Prostatakarzinoms (mHSPC) stellt mittlerweile eine Ausnahme dar. Die derzeitige Standardtherapie des mHSPC besteht aus einer Kombination: entweder ADT + neuartigen Hormontherapie (NHT) oder ADT + Chemotherapie. Aufgrund neuester Studiendaten und einer entsprechenden Zulassung (in Deutschland) nimmt die dreifache Kombination bestehend aus ADT + NHT + Chemotherapie Einzug in die Therapie des mHSPC. Die komplexer werdende mHSPC-Therapie erfordert die prätherapeutische Einteilung in ein „low“ vs. „high risk“, „low“ vs. „high volume“ und synchron vs. metachron metastasiertes HSPC. Zudem muss das Nebenwirkungsprofil der einzelnen Optionen beachtet und insbesondere eingeschätzt werden, ob der Patient Chemotherapie-fit vs. -unfit ist. Diese Übersicht gibt einen prägnanten Überblick über die relevanten Studien sowie die entsprechenden derzeit gültigen Empfehlungen und Zulassungen für Deutschland.

Abstract

At present, androgen deprivation therapy (ADT) as monotherapy for metastatic hormone-sensitive prostate cancer (mHSPC) should be an exception. The new standard of care is a doublet combination consisting of ADT + a new hormonal agent (NHA) or ADT + chemotherapy. Contemporary investigations even recommend a triplet therapy consisting of ADT + NHA + chemotherapy for selected mHSPC patients. The current evolution of mHSPC therapy demands a pretherapeutic classification of mHSPC: “low” vs. “high risk”, “low” vs. “high volume” and synchronous vs. metachronous mHSPC. Additionally, attention should be paid to the drug specific side effects and especially whether the patient is fit for chemotherapy. This article gives a concise overview of the key clinical trials, current guideline recommendations and drug approvals for Germany.

Schlüsselwörter

ADT - mHSPC - Doubletherapie - Tripletherapie - NHT

Keywords

ADT - mHSPC - Doublet Therapy - Triplet Therapy - NHA

Publication History

Received: 07 June 2023

Accepted after revision: 13 July 2023

Article published online:
22 August 2023

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