Aktuelle Urol 2022; 53(01): 60-63
DOI: 10.1055/a-1338-0202
Fallbericht

Nicht fernmetastasiertes kastrationsresistentes Prostatakarzinom (M0CRPC)

Apalutamid beim Hochrisiko-M0CRPC – Kasuistiken aus der SPARTAN-Studie und dem Apalutamid HärtefallprogrammNon-metastatic castration-resistant prostate cancer (M0CRPC)Apalutamide in high-risk M0CRPC: case reports from the SPARTAN study and the apalutamide compassionate use program
Philipp Spiegelhalder
1   Urologie Neandertal, Gemeinschaftspraxis für Urologie, Mettmann
,
Martin Bögemann
2   Universitätsklinikum Münster, Urology, Münster
› Author Affiliations

Zusammenfassung

Das Auftreten von Fernmetastasen stellt beim nicht fernmetastasierten kastrationsresistenten Prostatakarzinom (M0CRPC) einen prognostisch ungünstigen Wendepunkt dar. Dabei haben M0CRPC-Patienten mit kurzer PSA-Verdopplungszeit ein besonders hohes Progressionsrisiko. Für diese Patienten gab es lange Zeit, bis auf das abwartende Beobachten unter Beibehaltung der klassischen Androgendeprivationstherapie (ADT), keine weiteren Therapieoptionen. Das seit Januar 2019 verfügbare Next-Generation Antiandrogen Apalutamid verlängerte in der Zulassungsstudie SPARTAN beim Hochrisiko-M0CRPC das metastasenfreie Überleben signifikant gegenüber Placebo. Die vorliegenden Patientenfälle aus der SPARTAN-Studie und dem Apalutamid Härtefallprogramm sind Beispiele für die positiven Effekte, die Apalutamid im M0CRPC-Stadium erzielen kann.

Abstract

The occurrence of distant metastases represents a prognostically unfavourable turning point in non-metastatic castration-resistant prostate cancer (M0CRPC). M0CRPC patients with a short PSA doubling time have a particularly high risk of progression. For a long time, there was no further treatment option for these patients apart from watchful waiting while maintaining classic androgen deprivation therapy (ADT). Apalutamide, a next-generation anti-androgen available since January 2019, significantly increased metastasis-free survival compared with placebo in the pivotal SPARTAN trial in patients with high-risk M0CRPC. The presented patient cases from SPARTAN and the apalutamide compassionate use program are examples of the beneficial effects that apalutamide can achieve in the M0CRPC setting.



Publication History

Article published online:
21 April 2021

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