In a nutshell
This study examined the effectiveness of cabazitaxel (Jevtana) in patients with prostate cancer that has spread. This study concluded that cabazitaxel improved patient outcomes more than conventional hormone therapy.
Androgen deprivation therapy (ADT) remains a standard treatment for patients with prostate cancer. ADT targets androgen hormones, which are known to cause the growth of prostate cancers. Tumors that stop responding to ADT are called castration-resistant. This type of prostate cancer can be challenging to treat.
Chemotherapy drugs can also be combined with ADT. Cabazitaxel is a chemotherapy drug used for cancer that has spread outside the prostate gland. Unlike other agents, cabazitaxel has been shown to have fewer side effects in patients with prostate cancer. Whether patients who have had ADT before can benefit from cabazitaxel is unclear.
Methods & findings
This study included 225 patients with prostate cancer that has spread. 129 patients received cabazitaxel. In the control group, 126 patients received either abiraterone (Zytiga) or enzalutamide (Xtandi). Patients were followed up for an average of 9.2 months.
More patients in the cabazitaxel group responded to treatment than the control group (36.5% vs. 11.5%). Significantly more patients in the cabazitaxel group had changes in prostate antigen levels, indicating tumor shrinkage (35.7% vs. 13.5%).
At follow-up, the cabazitaxel group survived for 11.0 months compared to 4.4 months in the control group. Cabazitaxel treatment significantly reduced mortality risk by 36%.
At follow-up, the cabazitaxel group survived for 8.0 months without tumor growth or spread compared to 3.0 months in the control group. Cabazitaxel treatment reduced the risk of tumor growth or mortality by 46%. This risk decreased by 43% compared to enzalutamide and by 56% compared to abiraterone.
Overall, 98.4% (cabazitaxel) and 94.4% (control) had side effects. 38.9% (cabazitaxel) and 38.7% (control) reported serious side effects. Fatigue was most common (4.0% vs. 2.4%). Diarrhea and low white blood cell count with fever were also reported (both 3.2% vs. 0%).
The bottom line
This study concluded that cabazitaxel improved outcomes for patients with prostate cancer that has spread compared to conventional ADT drugs.
The fine print
This study was funded by Sanofi, the manufacturer of cabazitaxel.
Talk to your oncology team about whether cabazitaxel may be suitable for you.
Published By :
The New England Journal of Medicine
Sep 30, 2019
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