Effect of cabazitaxel vs abiraterone or enzalutamide on patient-reported outcomes in mCRPC: A pre-planned EQ-5D-5L analysis of the CARD study - Neal Shore

Neal Shore, MD, FACS joins Alicia Morgans, MD, MPH to discuss the outcomes of the CARD trial, Cabazitaxel Versus the Switch to Alternative AR-targeted Agent (Enzalutamide or Abiraterone) in Metastatic Castration-resistant Prostate Cancer (mCRPC) Patients Previously Treated With Docetaxel and Who Rapidly Failed a Prior AR-targeted Agent (CARD) in a recent analysis presented at the AUA 2020 Virtual meeting. A phase IV trial that randomized patients with evidence of progressive disease within 12 months of prior androgen receptor-targeted therapy, before or after prior docetaxel, to cabazitaxel versus abiraterone or enzalutamide with a primary endpoint of radiographic progression-free survival (rPFS).  CARD met its primary objective; cabazitaxel more than doubled rPFS vs abiraterone or enzalutamide.  Further, cabazitaxel reduced the risk of death by 36% vs abiraterone or enzalutamide.  Cabazitaxel also improved pain, time to pain progression, time to SSEs.  The safety profile of cabazitaxel was manageable, with 3% of patients developing febrile neutropenia. Also, changes in VAS and utility score of EQ-5D-5L numerically favored cabazitaxel and the results support the use of cabazitaxel over abiraterone or enzalutamide as a standard of care in patients previously treated with docetaxel who progressed within 12 months with the alternative ARi. In their consideration of patients' response to the treatment, Dr. Morgans and Dr. Shore also highlight the positive outcomes of patients who received cabazitaxel outside of the CARD trial, referencing forthcoming real-world data from multiple international centers.


Neal Shore, MD, FACS, is the Medical Director of the Carolina Urologic Research Center. He practices with Atlantic Urology Clinics in Myrtle Beach, South Carolina

Alicia Morgans, MD, MPH Associate Professor of Medicine in the Division of Hematology/Oncology at the Northwestern University Feinberg School of Medicine in Chicago, Illinois.

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