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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. 1Clinical Medicine, Macquarie University, Sydney, New South Wales, Australia
  2. 2Clinical 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}yahoo.com

Abstract

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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