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Continuing cabazitaxel beyond 10 cycles for metastatic castrate-resistant prostate cancer: is there a benefit?
  1. Loma AL-Mansouri1,
  2. Malmaruha Arasaratnam2,
  3. Howard Gurney1
  1. 1 Clinical Medicine, Macquarie University, Sydney, New South Wales, Australia
  2. 2 Clinical Medicine, Westmead Hospital, Westmead, New South Wales, Australia
  1. Correspondence to Dr Loma AL-Mansouri, Clinical Medicine, Macquarie University, Sydney, NSW 2109, Australia; lametah{at}


Aim Cabazitaxel prolongs survival in patients with metastatic castration-resistant prostate cancer in the postdocetaxel setting. We investigate the benefit of continuing cabazitaxel beyond 10 cycles in patients who are clinically responding without significant toxicity.

Methods A comparison was made between patients who received cabazitaxel for >10 cycles and those who had ≤10 cycles. Overall survival (OS), prostate-specific antigen (PSA) response, alkaline phosphatase (ALP) changes and treatment-associated adverse events were evaluated.

Results The median OS was 9 months (range 0.75–59), with OS significantly higher in patients who received extended duration of treatment: 14 months (range 3–90) vs 7 months (range 1.3–21) in patients treated with 4–10 cycles (HR 0.28, 95% CI 0.1 to 0.74, p=0.01). PSA decline did not show a significant correlation with OS (PSA decline ≥50%, p=0.54). Furthermore, there was no significant difference in OS between patients who had a normal versus high ALP at baseline. There was no clear evidence of cumulative toxicity in those having >10 cycles.

Conclusion A substantial proportion of patients with metastatic castration-resistant prostate cancer were able to receive more than 10 cycles of cabazitaxel without clinically relevant cumulative toxicity.

  • urological tumours
  • cabazitaxel
  • taxane
  • metastatic castration-resistant prostate cancer
  • duration of treatment
  • number of cycles

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