Metastasiertes Prostatakarzinom

The standard treatment for newly diagnosed castration-sensitive metastatic prostate cancer is androgen deprivation therapy (ADT) with luteinizing hormone-releasing hormone (LHRH) agonists or antagonists. Recently, randomized controlled studies have shown a significant survival advantage for the combination of ADT plus chemotherapy (docetaxel, six cycles) over ADT alone. Thus, ADT plus docetaxel should be offered to eligible patients. For metastatic castration-resistant prostate cancer (mCRPC), several new compounds with different mechanisms of action have been introduced in recent years. Abiraterone, enzalutamide, docetaxel, cabazitaxel, and ²²³Ra can be used in these patients. Due to the lack of head-to-head trials, the optimal sequence of these drugs is still under discussion; however, median overall survival in these patients has been improved to almost 3 years. For treatment monitoring in mCRPC, response and progression assessments, laboratory tests, imaging, and clinical parameters are used.