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Prostataspezifische Membranantigen(PSMA)-basierte Diagnostik und Therapie des Prostatakarzinoms

Prostate-specific membrane antigen (PSMA)-based diagnostics and treatment of prostate cancer

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Zusammenfassung

Hintergrund

Die Positronenemissionstomographie/Computertomographie (PET/CT) mit Liganden des Prostataspezifischen Membranantigens (PSMA) und die PSMA-Therapie haben sich seit ihrer klinischen Einführung in 2011 weltweit rasant ausgebreitet.

Fragestellung

Aktuelle Erkenntnisse sowohl über die PSMA-PET/CT als auch über die PSMA-Therapie werden zusammengefasst.

Material und Methode

Erkenntnisse aus der Literatur und Erfahrungen der Autoren wurden zusammengetragen.

Ergebnisse

Es zeigt sich eine sehr hohe Sensitivität und Spezifität der PSMA-PET/CT sowohl beim Rezidivprostatakarzinom (‑PC) als auch beim Primärstaging des PC mit mittlerem und hohem Risikoprofil. Die Ergebnisse der PSMA-Therapie als Drittlinientherapie bei Patienten mit metastasiertem, kastrationsresistentem PC sind vielversprechend.

Schlussfolgerungen

Die PSMA-PET/CT hat sich mittlerweile als Goldstandard in der Diagnostik des Rezidiv-PC etabliert und ist dabei, dieselbe Rolle auch beim Primärstaging des PC mit mittlerem und hohem Risikoprofil zu übernehmen. Die PSMA-Therapie wird in einer stets wachsenden Zahl an Zentren als Drittlinientherapie bei metastasiertem, kastrationsresistentem PC routinemäßig durchgeführt.

Abstract

Background

Since their clinical introduction in 2011, PSMA-PET/CT (PSMA: prostate-specific membrane antigen) as well as PSMA therapy of prostate cancer (PC) have spread rapidly worldwide.

Objectives

To summarize the current knowledge about both PSMA-PET/CT and PSMA therapy of PC.

Methods

The knowledge derived from the literature as well as the authors’ experiences were collected in this review.

Results

PSMA-PET/CT demonstrates a very high sensitivity and specificity for the detection of recurrent PC as well as for the primary staging of intermediate- and high-risk PC. PSMA therapy shows promising results in third-line treatment for patients with castration-resistant, metastatic PC.

Conclusions

PSMA-PET/CT is meanwhile established as the gold standard for the detection of recurrent PC and is in the process of assuming the same role for primary staging of intermediate- to high-risk PC. PSMA therapy serves as a promising third-line therapy in an increasing number of centers.

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Authors and Affiliations

  1. Klinik für Nuklearmedizin, Inselspital Bern, Freiburgstraße 18, 3010, Bern, Schweiz

    A. Afshar-Oromieh, I. Alberts, C. Sachpekidis & A. Rominger

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  1. A. Afshar-Oromieh
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  2. I. Alberts
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  3. C. Sachpekidis
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Correspondence to A. Afshar-Oromieh.

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Interessenkonflikt

A. Afshar-Oromieh, I. Alberts, C. Sachpekidis und A. Rominger geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Afshar-Oromieh, A., Alberts, I., Sachpekidis, C. et al. Prostataspezifische Membranantigen(PSMA)-basierte Diagnostik und Therapie des Prostatakarzinoms. Urologe 58, 1429–1434 (2019). https://doi.org/10.1007/s00120-019-01067-x

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