The CABASTY study showed that more frequent administration of a lower dose of cabazitaxel (CBZ) reduced toxicity in older men with metastatic castration-resistant prostate cancer (mCRPC), without compromising efficacy. Here, we investigated the impact of a biweekly CBZ schedule on patient-reported pain and health-related quality of life (HRQoL).
We randomized 196 patients from 25 centers (1:1, stratified by age and G8 score) to the biweekly CBZ16 (CBZ 16 mg/m2) experimental arm or the triweekly CBZ25 (CBZ 25 mg/m2) control arm (CABASTY study, NCT02961257). We assessed pain using the Numeric Pain Rating Scale and HRQoL using the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire.
A total of 141 patients were available for a pain and 160 for an HRQoL analysis. Median time to pain progression (stratified hazard ratio [HR]: 1.7, confidence interval [CI]: 0.67-4.22, p = 0.3) and median time to first opiate use (stratified HR: 1.05, CI: 0.44-2.55, p = 0.9) did not differ between arms. We did not see a significant difference in median time to deterioration of FACT-P total score between treatments (stratified HR: 0.88, CI: 0.47-1.7, p = 0.7). Interestingly, the time to onset of several adverse events was significantly longer in the biweekly CBZ16 group.
HRQoL did not significantly differ between the biweekly CBZ16 and the standard schedule. Additionally, onset of some adverse events was delayed. These results may increase health care providers' confidence in using CBZ in older patients with mCRPC who are denied chemotherapy.
Androgen receptor pathway inhibitors are often preferred to taxane chemotherapy as a treatment of second or subsequent line in older metastatic castration-resistant prostate cancer patients due to more frequent treatment-related toxicities. Here, we showed that quality of life and pain did not differ significantly with an adapted schedule of cabazitaxel (CBZ), compared with the standard regimen. This CBZ schedule could increase eligibility of older patients for chemotherapy.
European urology oncology. 2024 Aug 13 [Epub ahead of print]
Stephane Oudard, Yohann Tran, Carole Helissey, Charles Vauchier, Raffaele Ratta, Mostefa Bennamoun, Eric Voog, Ali Hasbini, Antoine Thiery-Vuillemin, Kais Aldabbagh, Carolina Saldana, Emmanuel Sevin, Eric Amela, Gunhild Von Amsberg, Nadine Houede, Dominique Besson, Susan Feyerabend, Martin Boegemann, David Pfister, Martin Schostak, Olivier Huillard, Frederic Di Fiore, Amandine Quivy, Dewi Vernerey, Antoine Falcoz, Karima Youcef-Ali, Salma Kotti, Eve M Lepicard, Philippe Barthelemy
Medical oncology Department, Georges-Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, Paris, France; Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Georges-Pompidou European Hospital, AP-HP, Paris Cité University, Paris, France. Electronic address: ., Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Georges-Pompidou European Hospital, AP-HP, Paris Cité University, Paris, France., Oncology Department, Begin Military Hospital, Saint-Mandé, France., Medical oncology Department, Georges-Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, Paris, France., Oncology Department, Foch Hospital, Suresnes, France., Oncology Department, Institute Mutualiste Montsouris, Paris, France., Oncology Department, Jean Bernard Center, Le Mans, France., Oncology Department, Clinique Pasteur Lanroze, Brest, France., Oncology Department, Jean-Minjoz University Hospital, Besançon, France., Oncology Department, Polyclinique Saint Côme, Compiègne, France., Oncology Department, Henri Mondor University Hospital, Paris Est Créteil University, TRePCa, Créteil, France., Oncology Department, Maurice Tubiana Centre, Caen, France., Oncology Department, Les Dentellières Cancer Centre, Valenciennes, France., Oncology Department, Prostate Cancer Center, Hamburg-Eppendorf University Hospital, Hamburg, Germany., Oncology Department, Gard Cancer Research Institute, Nîmes Caremeau University Hospital, Montpellier University, Montpellier, France., Oncology Department, Armorican Centre of Radiotherapy and Oncology, Plérin, France., Studienpraxis Urologie Clinical Investigation Centre, Nürtingen, Germany., Urology Department, Münster University Hospital, Münster, Germany., Urology Department, Uro-oncology and Robot-assisted Surgery, Köln University Hospital, Köln, Germany., Urology Department, Uro-oncology, Robot-assisted and Focal Therapy, Magdeburg University Hospital, Magdeburg Otto von Guericke University, Magdeburg, Germany., Oncology Department, Cochin University Hospital, AP-HP, Paris, France., Uro-digestive Oncology Unit, Rouen University Hospital, Rouen, France., Oncology Department, Saint André Hospital, Bordeaux, France., EFS, INSERM, UMR RIGHT, Franche-Comté University, Besançon, France; Methodology and Quality of Life Unit in Oncology, Besançon University Hospital, Besançon, France., Fondation de l'APHP, AP-HP, Paris, France., Oncology Department, Institut de Cancerologie Strasbourg Europe (ICANS), Strasbourg, France.