Abstract
The purpose of this study was to evaluate the efficacy of cabazitaxel for patients with metastatic castration-resistant prostate cancer (mCRPC) after sequential therapy with docetaxel (DTX) and single or dual regimens of novel androgen receptor-axis-targeted (ARAT) agents. We retrospectively reviewed 84 consecutive patients treated with cabazitaxel at Kobe University Hospital and related hospitals from September 2014 to September 2016. The association of each prognostic parameter with progression-free survival (PFS) was evaluated, including the sequence of therapy. Patients were divided according to their treatment after receiving cabazitaxel as follows: group 1 (after DTX and single regimen of novel ARAT agent) and group 2 (after DTX and dual novel ARAT agents). Median PFS for cabazitaxel treatment was 10.3 months (range 4.5–14.2 months). Prostate-specific antigen (PSA) response rates (≥30%) were 46.8 and 46.1% in group 1 and group 2, respectively [p = 0.96, hazard ratio (HR) 1.02, 95% confidence interval (CI) 0.57–1.80]. PSA response rates (≥50%) were 43.8 and 26.9% in patients of group 1 and group 2, respectively (p = 0.18, HR 1.54, 95% CI 0.78–3.04). Univariate analysis revealed that PFS for cabazitaxel treatment was significantly associated with baseline alkaline phosphatase, bone metastasis, and prior sequential therapy. Multivariate analysis revealed that bone metastasis and prior sequential therapy were independently associated with PFS. Prior sequential therapy with single regimen or dual regimens of novel ARAT agents was independently associated with PFS of patients with mCRPC treated with cabazitaxel. The effect of cabazitaxel after the administration of DTX and single novel ARAT agent was more sustained.
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References
Cornford P, Bellmunt J, Bolla M, Briers E, Santis MD, Gross T, et al. EAU-ESTRO-SIOG guidelines on prostate cancer. Part II: treatment of relapsing, metastatic, and castration-resistant prostate cancer. Eur Urol. 2017;71:630–42.
Al Nakouzi N, Le Moulec S, Albigès L, Wang C, Beuzeboc P, Gross-Goupil M, et al. Cabazitaxel remains active in patients progressing after docetaxel followed by novel androgen receptor pathway targeted therapies. Eur Urol. 2015;68:228–35.
De Bono JS, Oudard S, Ozguroglu M, Hansen S, Machiels JP, Kocak I, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomized open-label trial. Lancet. 2010;376:1147–54.
Sonpavde G, Bhor M, Hennessy D, Bhowmik D, Shen L, Nicacio L, et al. Sequencing of cabazitaxel and abiraterone acetate after docetaxel in metastatic castration-resistant prostate cancer: treatment patterns and clinical outcomes in multicenter community-based US oncology practices. Clin Genitourin Cancer. 2015;13:309–18.
Wissing MD, Coenen JL, Van Den Berg P, Westgeest HM, van den Eerwegh AJ, van Oort IM, et al. CAST: a retrospective analysis of cabazitaxel and abiraterone acetate sequential treatment in patients with metastatic castrate-resistant prostate cancer previously treated with docetaxel. Int J Cancer. 2015;136:E760–72.
Maines F, Caffo O, Veccia A, Trentin C, Tortora G, Galligioni E, et al. Sequencing new agents after docetaxel in patients with metastatic castration-resistant prostate cancer. Crit Rev Oncol Hematol. 2015;96:498–506.
Gillessen S, Omlin A, Attard G, de Bono JS, Efstathiou E, Fizazi K, et al. Management of patients with advanced prostate cancer: recommendations of the St. Gallen Advanced Prostate Cancer Consensus Conference (APCCC) 2015. Ann Oncol. 2015;26:1589–604.
Chi K, Hotte SJ, Joshua AM, North S, Wyatt AW, Collins LL, et al. Treatment of mCRPC in the AR-axis-targeted therapy-resistant state. Ann Oncol. 2015;26:2044–56.
Mohler JL, Armstrong AJ, Bahnson RR, D’Amico AV, Davis BJ, Eastham JA, et al. Prostate Cancer, Version 1.2016. J Natl Compr Cancer Netw. 2016;14:19–30.
Pezaro CJ, Omlin AG, Altavilla A, Lorente D, Ferraldeschi R, Bianchini D, et al. Activity of cabazitaxel in castration-resistant prostate cancer progressing after docetaxel and next-generation endocrine agents. Eur Urol. 2014;66:459–65.
Meisel A, von Felten S, Vogt DR, Liewen H, de Wit R, de Bono J, et al. Severe neutropenia during cabazitaxel treatment is associated with survival benefit in men with metastatic castration-resistant prostate cancer (mCRPC): a post hoc analysis of the TROPIC phase III trial. Eur J Cancer. 2016;56:93–100.
Halabi S, Lin CY, Small EJ, Armtrong AJ, Kaplan EB, Petrylak D, et al. Prognostic model predicting metastatic castration-resistant prostate cancer survival in men treated with second-line chemotherapy. J Natl Cancer Inst. 2013;105:1729–37.
Badrising SK, van der Noort V, Hamberg P, Coenen JL, Aarts MJ, van Oort IM, et al. Enzalutamide as a fourth-or fifth-line treatment option for metastatic castration-resistant prostate cancer. Oncology. 2016;91:267–73.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Bando, Y., Hinata, N., Terakawa, T. et al. Activity of cabazitaxel in patients with metastatic castration-resistant prostate cancer after treatment with single or dual regimens of novel androgen receptor-targeting agents. Med Oncol 34, 163 (2017). https://doi.org/10.1007/s12032-017-1024-0
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DOI: https://doi.org/10.1007/s12032-017-1024-0