Germany has become a global leader in the treatment of metastatic prostate cancer, offering advanced, individualized care backed by cutting-edge research, innovative technologies, and a multidisciplinary approach. In 2025, the therapeutic landscape for advanced prostate cancer in Germany is marked by remarkable progress—ranging from radioligand therapy to precision imaging and immunotherapy. This article explores the latest treatment options, top German specialists, and treatment outcomes based on current clinical data.
New and Advanced Treatment Methods for Metastatic Prostate Cancer
Germany’s major university hospitals and cancer centers offer some of the most comprehensive and research-driven treatments for metastatic prostate cancer. The therapies below represent the most recent and effective modalities now available to both German and international patients.
PSMA-Targeted Radioligand Therapy (RLT)
Radioligand therapy (RLT) targeting prostate-specific membrane antigen (PSMA) is one of the most transformative treatments currently available in Germany for metastatic castration-resistant prostate cancer (mCRPC). This therapy combines a radioactive isotope such as Lutetium-177 (Lu-177) with a PSMA-targeting molecule, delivering radiation directly to prostate cancer cells while sparing healthy tissue.
Patients receiving Lu-177-PSMA therapy often show significant reductions in PSA levels, tumor burden, and bone metastases. It is particularly effective in patients who have exhausted hormonal and chemotherapy options. In 2025, several German clinics offer not only Lu-177, but also Actinium-225-PSMA, an alpha emitter with even higher cytotoxic potential for resistant tumors.
Advanced Imaging and Theranostics
Germany leads in the clinical application of PSMA PET/CT and PET/MRI scans, essential for precise staging, restaging, and therapy planning. These scans are particularly effective in identifying metastases not visible through conventional imaging, thus optimizing patient selection for RLT and other targeted therapies.
Theranostic strategies—where the same PSMA molecule is used for both imaging and treatment—represent a central principle of personalized prostate cancer care in Germany.
PARP Inhibitors for Genomic-Driven Therapy
Germline and somatic testing are now standard practice in German oncology centers treating metastatic prostate cancer. Patients with mutations in BRCA1, BRCA2, or other DNA damage repair genes are candidates for PARP inhibitors such as Olaparib or Rucaparib, which interfere with cancer cell DNA repair mechanisms.
In 2025, PARP inhibitors are being used earlier in the disease course, even in combination with androgen receptor pathway inhibitors, for enhanced therapeutic response in genomically selected patients.
Bipolar Androgen Therapy (BAT)
BAT is an innovative concept gaining ground in German clinical trials. It involves rapidly cycling between high and low testosterone levels to shock prostate cancer cells that have adapted to castration-resistant conditions. Initial results show promise in resensitizing tumors to conventional androgen deprivation therapy (ADT) and even chemotherapy.
While still investigational, BAT is increasingly explored in clinical settings for patients with progression despite standard hormonal treatments.
Immunotherapy and Cellular Approaches
Though prostate cancer has traditionally been less responsive to immunotherapy, German researchers are now deploying immune checkpoint inhibitors in selected patients, particularly those with microsatellite instability (MSI-high) or high tumor mutational burden. Trials are also underway exploring CAR-T cell therapy for metastatic prostate cancer, though availability remains limited to major academic research institutions.
Additionally, dendritic cell-based vaccines and T-cell engagers are under development in German biotech collaborations, offering new hope for durable immune responses.
High-Intensity Focused Ultrasound (HIFU) for Oligometastatic Disease
For patients with limited bone or nodal metastases, focal therapies like HIFU are being used in Germany to target metastatic lesions directly. This non-invasive technique allows local control of disease with minimal side effects and can delay the need for systemic therapy. Combined with stereotactic body radiotherapy (SBRT), it is part of a growing movement toward aggressive local therapy in oligometastatic prostate cancer.
Top Prostate Cancer Specialists in Germany (2025)
Germany is home to many world-renowned experts in urology, nuclear medicine, and oncology who are at the forefront of metastatic prostate cancer treatment.
Prof. Dr. med. Stefan Dresel
A leading nuclear medicine specialist, Prof. Dresel is internationally recognized for his work with PSMA-based radioligand therapies and PET imaging. He has contributed significantly to advancing Lu-177 and Actinium-225 protocols and refining patient selection strategies.
Prof. Dr. med. Jürgen Gschwend
Chairman of the Department of Urology at one of Germany’s top academic hospitals, Prof. Gschwend is a pioneer in uro-oncology. He specializes in complex prostate cancer surgeries, including robot-assisted procedures, and is a key figure in translational prostate cancer research.
Prof. Dr. med. Mark Schrader
Prof. Schrader focuses on advanced prostate cancer, precision oncology, and clinical trials. His work bridges research and patient care, particularly in genomic-driven therapies and targeted systemic treatments for mCRPC.
Prof. Dr. med. Samer Ezziddin
Renowned for his role in developing and implementing PSMA radioligand therapy, Prof. Ezziddin has treated hundreds of patients with Lu-177 and Ac-225 PSMA. He is actively involved in clinical trials assessing safety, dosimetry, and long-term outcomes of theranostic approaches.
Prof. Dr. med. Andreas Gross
A urology expert, Prof. Gross has extensive experience in robotic prostate surgery, focal therapy, and advanced hormonal treatments. He’s also involved in cross-disciplinary prostate cancer care models integrating nuclear medicine and radiation oncology.
Outcomes and Statistical Insights (2025)
Germany’s commitment to quality care, early detection, and high-tech therapies results in excellent clinical outcomes for metastatic prostate cancer:
- Over 65% of patients receiving Lu-177 PSMA therapy show a significant PSA decline (>50%), with prolonged progression-free survival.
- Median overall survival for mCRPC patients receiving RLT has extended beyond 18–22 months, even in heavily pretreated populations.
- Patients with BRCA mutations treated with PARP inhibitors experience a 70% improvement in radiographic progression-free survival.
- The integration of precision imaging (PSMA PET) leads to a 30–40% improvement in staging accuracy, allowing earlier intervention.
- Enrollment in over 150 active clinical trials across German cancer centers ensures access to novel agents and personalized protocols.
Metastatic prostate cancer treatment in Germany has entered a new era of precision, innovation, and personalization. With access to radioligand therapies, genomic medicine, focal interventions, and globally respected medical experts, Germany offers one of the most advanced care environments for patients with advanced disease. As we move through 2025, German centers continue to push the boundaries of science to deliver longer survival and better quality of life for patients around the world.