Resistenzmechanismen unter antihormoneller Therapie des fortgeschrittenen Prostatakarzinoms

Zusammenfassung

Durch die Entwicklungen der letzten Jahren stehen mit Abirateronacetat und Enzalutamid neben Docetaxel effektive Möglichkeiten für die Erstlinientherapie des metastasierten kastrationsresistenten Prostatakarzinoms (mCRPC) zur Verfügung. Unter allen verfügbaren Therapien entwickeln sich jedoch im Therapieverlauf Resistenzen und zum Teil auch Kreuzresistenzen, die zu einem Versagen der jeweiligen Therapien und ggf. einer eingeschränkten Wirksamkeit der Folgetherapien führen können. Hierbei scheint es anhand präklinischer Daten Unterschiede zwischen dem Wirkmechanismus bezüglich Abirateronacetat und Enzalutamid zu geben. Sollten sich diese Mechanismen in klinischen Studien bestätigen, könnte dies die Therapieempfehlungen zur Sequenz beim mCRPC vereinfachen.

Abstract

With the development of Abiraterone and Enzalutamide new treatment option have become available in addition to Docetaxel for first-line treatment of castration resistant prostate cancer. However, resistance and ultimately failure occurs inevitably with all available treatment options. Moreover, cross-resistance leads to considerably reduced efficacy in second-line treatment. Preclinical data suggest discriminative mechanisms of resistance development for Abiraterone and Enzalutamide. Clinical confirmation of these putative mechanisms for treatment failure might facilitate recommendations for future sequencing of these drugs.

Schlüsselwörter

Prostatakarzinom - antihormonelle Therapie - Resistenz - Abirateronacetat - Enzalutamid

Key words

prostate cancer - antihormone therapy - resistance - abiraterone acetate - enzalutamide

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