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Reduced dose of cabazitaxel in metastatic castration-resistant prostate cancer

from PROSELICA trial to the real life

A single institution experience

Vallome, Giacomoa; Cattrini, Carlob; Messina, Carloc; Cerbone, Luigib; Boccardo, Francescob; Zanardi, Elisaa,,b

doi: 10.1097/CAD.0000000000000805
Clinical Papers
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The phase III PROSELICA trial showed that cabazitaxel 20 mg/m2 (C20) was not inferior and better tolerated compared to cabazitaxel 25 mg/m2 (C25) in patients with metastatic castration-resistant prostate cancer (mCRPC) who had progressed during or after docetaxel. Here, we report on a real-world retrospective analysis concerning the safety and the activity of C20 schedule in patients with mCRPC treated at our Institution. We identified 35 patients with mCRPC who received C20 as baseline dose treatment because they were frail or experienced serious toxicities to previous treatments. Adverse events assessment was performed at each visit during the treatment. Progression-free survival (PFS) and overall survival (OS) curves were obtained using the Kaplan–Meyer product-limit estimator. Median age was 71 years. All patients received a previous treatment with docetaxel; 19 patients (54%) received one additional line of therapy and 9 (26%) two or more. Patients received a median of 4 cycles (range: 2–10). Only one patient experienced grade 3 neutropenia (3%), two patients grade 3 anemia (6%), and one patient grade 3 fatigue (3%); three patients were treated with prophylactic Granulocyte colony-stimulating factor (9%). The most frequent adverse events of all grades were: anemia (39%), fatigue (33%), and diarrhea (15%). Median PFS was 3.7 months [95% confidence interval (CI): 3.31–4.09]; median OS was 10.3 months (95% CI: 4.63–15.97). Our real-world analysis confirms that C20 is a feasible option for elderly and heavily pretreated patients with mCRPC, showing activity and good tolerability.

aAcademic Unit of Medical Oncology, IRCCS San Martino Polyclinic Hospital

bDepartment of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, Genoa

cMedical Oncology Unit, Santa Chiara Hospital, Trento, Italy

Received 5 March 2019 Revised form accepted 25 April 2019

Correspondence to Elisa Zanardi, MD, Academic Unit of Medical Oncology, IRCCS San Martino Polyclinic Hospital; Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genoa, L.go R. Benzi 10, 16132, Genoa, Italy, Tel: +39 010 555 8930; fax: +39 010 555 6385; e-mail: zanardielisa@yahoo.it

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