title: Austrian recommendations on Targeted Hormone Therapy for metastatic, castration-resistant prostate cancer.
abstract: In recent years, new therapeutic options have brought improvements in the treatment of metastatic, castration-resistant prostate cancer. Targeted Hormone Therapy (THT) represents a novel therapeutic component for which recent studies have shown a maximum benefit in the time between failure of androgen deprivation therapy (patient is metastatic and still pain-free) and prior to chemotherapy. Prostate cancer experts of the Austrian Society of Urology and Andrology (ÖGU), the Working Group for Urologic Oncology as part of the ÖGU, and the Professional Association of Austrian Urologists (BvU) have developed recommendations for the treatment of patients with asymptomatic or mildly symptomatic metastatic, castration-resistant prostate cancer. The definition of failure of classical hormonal therapy has been based on the guidelines of the German Society of Urology (Deutsche Gesellschaft für Urologie, DGU) and the European Association of Urology (EAU). Criteria for the initiation of treatment with hormonal or chemotherapy include: Castration resistance with increase of prostate-specific antigen (PSA) Evidence of metastases in imaging No or mild symptoms Quality of Life Index of the Eastern Cooperative Oncology Group (ECOG) 0-1 (ECOG 2 requires individualized decision) [1]. Treatment should only be initiated when all of these four criteria are applicable, with the age of the patient being no exclusion criterion. First-line therapies for these patients include abiraterone, enzalutamide, and docetaxel as well as radium-223. The manuscript refers only to treatment regimens available in Austria.Selection of the initial treatment option-starting with THT or chemotherapy-should be determined based on the individual patient characteristics. When using abiraterone or enzalutamide, re-staging within 3-6 months is recommended.
authors.affiliation: Department of Urology and Andrology, Working Group Urologic Oncology (AUO), Hospital Barmherzige Brüder Vienna, Vienna, Austria. antonponholzer@hotmail.com.
authors.forename: Anton
authors.initials: A
authors.lastname: Ponholzer
authors.affiliation: Department of Urology, Austrian Society of Urology and Andrology (ÖGU), Hospital Barmherzige Schwestern Linz, Linz, Austria. wolfgang.loidl@bhs.at.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Loidl
authors.affiliation: European Prostate Center, University Hospital of Urology, Innsbruck, Austria. jasmin.bektic@uki.at.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Bektic
authors.affiliation: Urology and Andrology in Vienna, Professional Association of Austrian Urologists (BvU), Vienna, Austria. office@dorfinger.at.
authors.forename: Karl
authors.initials: K
authors.lastname: Dorfinger
authors.affiliation: Urology and Andrology, University Hospital, Salzburg, Austria. s.hruby@salk.at.
authors.forename: Stephan
authors.initials: S
authors.lastname: Hruby
authors.affiliation: Department of Urology and Andrology, Clinic Center Klagenfurt am Wörthersee, Klagenfurt am Wörthersee, Austria. klaus.jeschke@kabeg.at.
authors.forename: Klaus
authors.initials: K
authors.lastname: Jeschke
authors.affiliation: Urologic Outpatient Tumor Unit, University Hospital of Urology, Vienna, Austria. gero.kramer@meduniwien.ac.at.
authors.forename: Gero
authors.initials: G
authors.lastname: Kramer
authors.affiliation: Department of Urology, General Hospital of the City of Linz, Linz, Austria. steffen.krause@medz.at.
authors.forename: Steffen
authors.initials: S
authors.lastname: Krause
authors.affiliation: Urology & Andrology, Vienna, Austria. urodoc@chello.at.
authors.forename: Georg
authors.initials: G
authors.lastname: Ludvik
authors.affiliation: Department of Urology, Provincial Hospital Korneuburg, Korneuburg, Austria. mremzi@gmx.at.
authors.forename: Mesut
authors.initials: M
authors.lastname: Remzi
authors.affiliation: KABEG, Clinic Center Klagenfurt am Wörthersee, Klagenfurt am Wörthersee, Austria. michael.roider@kabeg.at.
authors.forename: Michael
authors.initials: M
authors.lastname: Roider
authors.affiliation: Department of Urology, Provincial Hospital Vöcklabruck, Vöcklabruck, Austria. franz.stoiber@gespag.at.
authors.forename: Franz
authors.initials: F
authors.lastname: Stoiber
mesh_terms: D000726:Androgen Antagonists / Q000592:standards / Q000627:therapeutic use*; D001317:Austria; D019317:Evidence-Based Medicine; D020249:Hormone Replacement Therapy / Q000592:standards*; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000592:standards*; D058990:Molecular Targeted Therapy / Q000592:standards*; D017410:Practice Guidelines as Topic; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists
keywords: Abiraterone; Enzalutamide; Metastatic, castration-resistant prostate cancer; Targeted Hormone Therapy; Treatment sequence
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