New drugs in prostate cancer
For the treatment of metastatic castration-resistant prostate cancer, there are some new drugs. A recent review was presented at the Annual Congress of the German Urologists in Hamburg.
Under a castration-resistant prostate cancer (CRPC) refers to prostate cancer, in which thePSA level (again) rises despite maximal androgen blockade (LH-RH analogue or LH-RH antagonist plus antiandrogen) and despite a Auslassversuchs of the antiandrogen (for more details on these methods s hormone therapy ). In such a tumor further treatment is palliative: It aims to preserve the quality of life or improve, and can alleviate discomfort, but requires little or no survival often. A standard of care there is for it not currently, most commonly by a treatment with docetaxel (a cytostatic agent , for more information see chemotherapy ). Lately, the following new drugs were approved:
Cabazitaxel: How docetaxel (see chemotherapy ) belongs to the so-called taxanes, cabazitaxel, which hinder cell division. It can be (together with prednisone, a corticosteroid) given if a treatment with docetaxel was unsuccessful. In the pivotal study, the survival time was therefore about 3 months longer than during therapy with mitoxantrone (an antineoplastic agent) plus prednisone.
Abiraterone: This compound blocks the production of androgens throughout the body, so in the testes, the adrenal glands and the tumor itself The latter seems to be responsible with making sure that a tumor will continue to grow regardless of the usual hormone therapy, so is castration resistant. Can abiraterone (together with prednisone) are also contemplated in metastatic CRPC after an unsuccessful chemotherapy with docetaxel. Under abiraterone plus prednisone survival time was about 4 months longer than under prednisone alone.
Denosumab: This is a so-called human monoclonal antibodies, that is a man-made human antitoxin. This particular protein is directed against an antigen, another protein, which activates its degradation in the bone. In men with prostate cancer who received hormone therapy (androgen deprivation a), bone density increased with denosumab. There has also been compared with zoledronic acid on bone complications later (see also palliative therapy ). An effect of denosumab on survival has not been established.
In Europe, not yet approved is a hormone therapy with abiraterone prior to chemotherapy and with a novel antiandrogen. The same applies to a number of new substances for immunotherapy and gene therapy (for both methods see more systemic therapy ) and other new substances for the treatment of bone metastases.
Swell
- 63 Congress of the DGU (German Society for Urology eV), Hamburg 14.-09.17.11, Academy Forum 1, Part 2 on 9/14/11 "New substances in urologic oncology"
- PCa in the late stage increasingly surrounded. Several new drugs in development - diverse mechanisms of action. Biermann, Cologne, Urological News 7-8/2011 p 1 +20
- DGU (German Society for Urology eV; eds.): Interdisciplinary guideline of quality S3 for early detection, diagnosis and treatment of different stages of prostate cancer. Version 1.03, March 2011. Latest version available on the website of the AWMF (Association of the Scientific Medical Societies eV) on the side of this guideline as PDF
- Heidenreich, A., et al.: Guidelines on prostate cancer. European Association of Urology (EAU) 2011. Latest version available at the EAU website on the page of this Guideline (click on "Prostate Cancer") as PDF (English)
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