We examined factors that may impact cabazitaxel treatment duration in a real-life setting in a compassionate use program, expanded access program, and prospective observational study in metastatic castration-resistant prostate cancer (mCRPC). Patients with mCRPC previously treated with docetaxel (N = 1,621) received cabazitaxel 25 mg/m2 intravenously every 3 weeks until disease progression, death, unacceptable toxicity or physician/patient decision. The median number of cabazitaxel cycles was six (range, 1-49); 708 patients (43.7%) received >6 cycles. Patients receiving >6 cycles tended to have a better Eastern Cooperative Oncology Group performance status of 0-1 (p = 0.0017 for ≤6 vs. >6 cycles). Overall, 348 patients (21.5%) were ≥75 years of age; 139 (39.9%) received >6 cycles. The main reason for discontinuation was disease progression; however, in patients receiving 1-2 cycles, the main reason for discontinuation was adverse events. Only 52 patients (3.2%) progressed during cycles 1-2. Cabazitaxel was well tolerated in these studies, which included some elderly and frail patients, offering clinicians an important treatment option in the management of mCRPC. Proactive management of adverse events may allow patients to receive a higher number of cabazitaxel cycles and derive greater benefit.
Cancers. 2020 Apr 17*** epublish ***
Zafar Malik, Giuseppe Di Lorenzo, Angelika Pichler, Ugo De Giorgi, Simon Hitier, Evelyne Ecstein-Fraisse, Ayse Ozatilgan, Joan Carles
Clinical Oncology, The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral CH63 4JY, UK., Department of Medicine and Health Sciences 'Vincenzo Tiberio', University of Molise, 86100 Campobasso, Italy., Department of Hematology and Oncology, Regional Hospital Hochsteiermark, 8700 Leoben, Austria., Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy., Department of Biostatistics, Sanofi, 91380 Chilly-Mazarin, France., Medical Evidence Generation, Sanofi, 75008 Paris, France., Global Medical Affairs Oncology, Sanofi, Cambridge, MA 02142, USA., Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain.