Background Prostate cancer is one of the most common cancers in Europe. Cabazitaxel, a tubulin-binding taxane drug as potent as docetaxel in cell lines, was the first treatment able to prolong survival for metastatic castration-resistant prostate cancer in the post-docetaxel setting.
Purpose Analysing the effectiveness and safety of cabazitaxel in a cohort of patients with castration-resistant metastatic prostate cancer after progression to docetaxel, and comparing the results to the literature.
Material and methods Study conducted from January 2013 until August 2016 in a third-level teaching hospital. Data were retrospectively obtained using the chemotherapy e-prescribing software (Oncofarm®) and the patients’ electronic medical records (Diraya®). The following information was recorded: demographic characteristics, performance status (PS), previous chemotherapy, and number of cycles and dose ofcabazitaxel. The overall survival (OS), and the progression-free survival (PFS) (measured as prostatic-specific antigen progression, tumour progression, pain progression or date of death due to any cause, whichever occurred first) were measured. The type and incidence of side effects was also recorded, as well as the need for granulocyte-colony stimulating factor (GCSF) support.
Results Twelve patients were included (mean age 64.1 (52–73)). Baseline PS was 0 in 25% of cases, and 1 in 75% of cases. On average, the number of cycles received was six. Cabazitaxel was given as a second-line treatment in 75% of patients, and in third line in 25% of them. OS was 17.34 months (95% CI: 16.01 to 18.67), whereas mean PFS was 4.32 months (95% CI: 3.82 to 4.82). Progression occurred in 41.7% of patients. Four patients deceased. Fifty per cent of patients required GCSF support at some point during therapy. In terms of safety, CTCAE grades 1–2 asthaenia (75%), diarrhoea (41.6%), and nausea and vomit (33.3%) were the most frequently associated side-effects, although only in 25% of cases they leaded to dose reduction.
Conclusion In this cohort of patients, both the OS and PFS were higher than the TROPHY trial by 2.24 and 1.52 months, respectively. Cabazitaxel-related adverse events occurred in most patients at some point during therapy, although they were mild, requiring dose reduction in a quarter of patients. However, larger studies are necessary in order to confirm these results.
References and/or Acknowledgements To my pharmacist colleagues
No conflict of interest
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