Neue Therapieoptionen des kastrationsresistenten Prostatakarzinoms

Metastatic castration-resistant prostate cancer (mCRPC) represents a therapeutic challenge. Numerous drug therapies have been approved in recent years, e.g., combination therapy comprising a poly (ADP-ribose) polymerase (PARP) inhibitor and a new hormonal agent (NHA), with a median overall survival (mOS) of up to 42 months. Treatment with a prostate-specific membrane antigen (PSMA)-targeted ¹⁷⁷Lu radioligand confers a survival advantage over standard treatment. For a dose modification of cabazitaxel to 16 mg/m² in 2‑week intervals, noninferiority compared to the standard dose schedule was demonstrated in addition to the almost complete elimination of the neutropenia risk. The average osteoporotic fracture risk during androgen deprivation therapy (ADT) is 11%. Alternatives are the monoclonal antibody denosumab and bisphosphonates.