1. Continuing cabazitaxel beyond 10 cycles for metastatic castrate-resistant prostate cancer: is there a benefit?
- Author
-
Malmaruha Arasaratnam, Howard Gurney, and Loma Al-Mansouri
- Subjects
Male ,Oncology ,medicine.medical_specialty ,Castrate-resistant prostate cancer ,030226 pharmacology & pharmacy ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,General Pharmacology, Toxicology and Pharmaceutics ,Adverse effect ,Original Research ,Cumulative toxicity ,Taxane ,business.industry ,Significant difference ,Prostate-Specific Antigen ,medicine.disease ,Prostatic Neoplasms, Castration-Resistant ,Treatment Outcome ,Cabazitaxel ,Toxicity ,Taxoids ,business ,medicine.drug - 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.
- Published
- 2019