Zusammenfassung
Ein Viertel der jährlich in Deutschland neu diagnostizierten Krebserkrankungen sind urologische Tumoren, deren Behandlung zunehmend komplexer und interdisziplinärer wird. Um Erkenntnisse aus der molekularbiologischen Forschung unmittelbar anwenden und in Therapiestudien umsetzen zu können, sind nach US-amerikanischem Vorbild auch in Deutschland Krebszentren, sog. Comprehensive Cancer Center, entstanden, in denen Forschungslaboratorien und Kliniken eng zusammenarbeiten. Am Beispiel des Prostatakarzinoms soll exemplarisch dargestellt werden, wie aktuell neue Erkenntnisse aus der molekularen und translationalen Forschung in neue Behandlungsansätze umgesetzt werden. Dabei ist das Stichwort der multimodalen Diagnostik und Therapie, d. h. eine Kombination verschiedener, zum Teil komplementärer Ansätze zur Erkennung und Behandlung des Tumors, aktuell von größter Bedeutung. Neben Definition des Prostatakarzinoms, Darstellung des Gleason-Scores und des Epstein-Gradings sollen die für den Therapiealgorithmus relevanten Risikoklassifikationen vorgestellt werden.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsLiteratur
Hadaschik B et al (2013) Urology in the concept of comprehensive cancer centers. Urologe A 52(9):1283–1289
Rothke M et al (2013) PI-RADS classification: structured reporting for MRI of the prostate. Rofo 185(3):253–261
Omlin A, Gillessen S (2012) Inhibitors of androgen and estrogen biosynthesis in castration-resistant prostate cancer. Urologe A 51(1):8–14
Holmberg L et al (2002) A randomized trial comparing radical prostatectomy with watchful waiting in early prostate cancer. N Engl J Med 347(11):781–789
Bill-Axelson A et al (2014) Radical prostatectomy or watchful waiting in early prostate cancer. N Engl J Med 370(10):932–942
Bratt O, Loman N (2015) Clinical management of prostate cancer in men with BRCA mutations. Eur Urol 68(2):194–195
Castro E et al (2015) Effect of BRCA mutations on metastatic relapse and cause-specific survival after radical treatment for localised prostate cancer. Eur Urol 68(2):186–193
Bellefqih S et al (2016) Combined radiation therapy and androgen deprivation in the management of prostate cancer: Where do we stand? Cancer Radiother 20(2):141–150
Miyamoto H, Rahman MM, Chang C (2004) Molecular basis for the antiandrogen withdrawal syndrome. J Cell Biochem 91(1):3–12
Stewart SB, Boorjian SA (2015) Radical prostatectomy in high-risk and locally advanced prostate cancer: Mayo Clinic perspective. Urol Oncol 33(5):235–244
Lee BH et al (2015) Are biochemical recurrence outcomes similar after radical prostatectomy and radiation therapy? Analysis of prostate cancer-specific mortality by nomogram-predicted risks of biochemical recurrence. Eur Urol 67(2):204–209
Sundi D et al (2014) Identification of men with the highest risk of early disease recurrence after radical prostatectomy. Prostate 74(6):628–636
Briganti A et al (2014) Prediction of outcome following early salvage radiotherapy among patients with biochemical recurrence after radical prostatectomy. Eur Urol 66(3):479–486
Abdollah F et al (2014) Impact of adjuvant radiotherapy on survival of patients with node-positive prostate cancer. J Clin Oncol 32(35):3939–3947
Scher HI et al (2008) Design and end points of clinical trials for patients with progressive prostate cancer and castrate levels of testosterone: recommendations of the Prostate Cancer Clinical Trials Working Group. J Clin Oncol 26(7):1148–1159
Eichholz A (2012) Putting the brakes on continued androgen receptor signaling in castration-resistant prostate cancer. Mol Cell Endocrinol 360(1–2):68–75
Tannock IF et al (2004) Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 351(15):1502–1512
Berthold DR et al (2008) Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer: updated survival in the TAX 327 study. J Clin Oncol 26(2):242–245
Georgi B et al (2014) Evolving therapeutic concepts in prostate cancer based on genome-wide analyses (review). Int J Oncol 45(4):1337–1344
Sweeney CJ et al (2015) Chemohormonal therapy in metastatic hormone-sensitive prostate cancer. N Engl J Med 373(8):737–746
Attard G et al (2012) Clinical and biochemical consequences of CYP17A1 inhibition with abiraterone given with and without exogenous glucocorticoids in castrate men with advanced prostate cancer. J Clin Endocrinol Metab 97(2):507–516
Danila DC et al (2010) Phase II multicenter study of abiraterone acetate plus prednisone therapy in patients with docetaxel-treated castration-resistant prostate cancer. J Clin Oncol 28(9):1496–1501
Ryan CJ et al (2015) Abiraterone acetate plus prednisone versus placebo plus prednisone in chemotherapy-naive men with metastatic castration-resistant prostate cancer (COU-AA-302): final overall survival analysis of a randomised, double-blind, placebo-controlled phase 3 study. Lancet Oncol 16(2):152–160
Sternberg CN et al (2014) Improved outcomes in elderly patients with metastatic castration-resistant prostate cancer treated with the androgen receptor inhibitor enzalutamide: results from the phase III AFFIRM trial. Ann Oncol 25(2):429–434
Loriot Y et al (2015) Effect of enzalutamide on health-related quality of life, pain, and skeletal-related events in asymptomatic and minimally symptomatic, chemotherapy-naive patients with metastatic castration-resistant prostate cancer (PREVAIL): results from a randomised, phase 3 trial. Lancet Oncol 16(5):509–521
A study of apalutamide (ARN-509) in men with non-metastatic castration-resistant prostate cancer (SPARTAN)
A study of JNJ-56021927 (ARN-509) and abiraterone acetate in participants with metastatic castration-resistant prostate cancer
Dy SM et al (2008) Evidence-based standards for cancer pain management. J Clin Oncol 26(23):3879–3885
Saad F et al (2002) A randomized, placebo-controlled trial of zoledronic acid in patients with hormone-refractory metastatic prostate carcinoma. J Natl Cancer Inst 94 (19):1458–1468
Smith MR et al(2012) Denosumab and bone-metastasis-free survival in men with castration-resistant prostate cancer: results of a phase 3, randomised, placebo-controlled trial. Lancet 379(9810):39–46
Araujo JC et al (2012) Dasatinib combined with docetaxel for castration-resistant prostate cancer: results from a phase 1-2 study. Cancer 118(1):63–71
Halperin EC et al (2007) Perez and Brady’s principles and practice of radiation oncology, 5. Aufl. Lippincott Williams & Wilkins
Taylor BS et al (2010) Integrative genomic profiling of human prostate cancer. Cancer Cell 18 (1):11–22
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer-Verlag GmbH Deutschland
About this chapter
Cite this chapter
Dieffenbacher, S., Georgi, B., Duensing, S., Hohenfellner, M. (2018). Multimodale Therapie des Prostatakarzinoms. In: Kesch, C., Hohenfellner, M. (eds) Aktuelles aus Klinik und Praxis der Urologie. WissenKompakt Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-55473-9_2
Download citation
DOI: https://doi.org/10.1007/978-3-662-55473-9_2
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-55472-2
Online ISBN: 978-3-662-55473-9
eBook Packages: Medicine (German Language)