{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:44:42Z","timestamp":1791935082441,"version":"4.3.4"},"reference-count":51,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aktuelle Urol"],"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Das metastasierte hormonsensitive Prostatakarzinom (mHSPC) weist eine ausgepr\u00e4gte klinische und biologische Heterogenit\u00e4t auf. W\u00e4hrend traditionelle klinische Parameter wie Metastasenlast oder Zeitpunkt der Metastasierung weiterhin prognostische Relevanz besitzen, gewinnen molekulare Biomarker zunehmend an Bedeutung f\u00fcr die individualisierte Therapieplanung. Genetische Alterationen in Tumorsuppressor- und DNA-Reparaturgenen, insbesondere BRCA-, PTEN- oder TP53-Ver\u00e4nderungen, sind mit aggressiveren Krankheitsverl\u00e4ufen und ung\u00fcnstiger Prognose assoziiert. Gleichzeitig er\u00f6ffnen diese Ver\u00e4nderungen neue therapeutische Ans\u00e4tze, beispielsweise durch den Einsatz von PARP- oder AKT-Inhibitoren. Neben genetischen Ver\u00e4nderungen spielen auch transkriptomische Merkmale eine wichtige Rolle. Insbesondere die Aktivit\u00e4t des Androgenrezeptor(AR)-Signalwegs beeinflusst Prognose und Therapieansprechen. Eine niedrige AR-Aktivit\u00e4t sowie geringe PSMA-Expressionen wurden mit reduzierter Sensitivit\u00e4t gegen\u00fcber antihormonellen Therapien und st\u00e4rkerer biologischer Heterogenit\u00e4t assoziiert. Umgekehrt scheint eine hohe PSMA-Expression mit besserem Ansprechen auf Androgendeprivationstherapie sowie PSMA-gerichtete Radioligandentherapien verbunden zu sein.Moderne bildgebende Verfahren wie die PSMA-PET tragen zu einem verbesserten Verst\u00e4ndnis der Tumorbiologie bei und f\u00fchren zunehmend zu einer Neubewertung klassischer Krankheitsstadien. Erg\u00e4nzend k\u00f6nnten Biomarker wie PSA-Nadir oder zirkulierende Tumor-DNA k\u00fcnftig helfen, Progressionsmuster pr\u00e4ziser vorherzusagen und individualisierte Therapieintensivierungs- oder Deeskalationsstrategien zu erm\u00f6glichen.Insgesamt deutet die aktuelle Evidenz darauf hin, dass die Integration genetischer, transkriptomischer und bildgebender Biomarker wesentlich zur biologischen Charakterisierung des mHSPC beitragen kann. Langfristig k\u00f6nnen diese Erkenntnisse die Grundlage f\u00fcr pr\u00e4zisere prognostische Modelle und personalisierte Therapiekonzepte schaffen.<\/jats:p>","DOI":"10.1055\/a-2970-7829","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:49:09Z","timestamp":1791931749000},"source":"Crossref","is-referenced-by-count":0,"title":["Molekularbasierte Diagnostik und Therapie des metastasierten hormonsensitiven Prostatakarzinoms (mHSPC)"],"prefix":"10.1055","author":[{"given":"Claudia","family":"Kesch","sequence":"additional","affiliation":[{"name":"University Hospital Essen, Germany","place":["Essen"],"department":["Urology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris","family":"Hadaschik","sequence":"additional","affiliation":[{"name":"University Hospital Essen, Germany","place":["Essen"],"department":["Urology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunhild","family":"von 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