BACKGROUND: Cabazitaxel and AA have been approved by the US Food and Drug Administration for use after docetaxel in mCRPC.
Recently, CAB appeared to be active when given after AA. AA is capable of inducing AR splice variants that confer ligand-independent AR transactivation. Because microtubule-targeting agents impair AR nuclear transport and activity, we raised concerns about CAB efficacy after AA failure in mCRPC.
PATIENTS AND METHODS: One hundred thirty mCRPC patients received AA after docetaxel treatment in compassionate programs. Of them, 24 (18.4%) subsequently received CAB. We retrospectively reviewed their data using conventional methods.
RESULTS: Twenty-four patients received a median of 4 (range, 1-13) CAB cycles. Nineteen (79.1%) of them received primary prophylaxis with growth factors. Median patient characteristics were: age 65 (range, 57-85) years; Gleason score: 8 (range, 6-10); and PSA: 128.1 (range, 0.01-1700) ng/mL. A PSA response (≥ 50% decrease from baseline) occurred in 6 (31.5%) of 19 evaluable patients (95% confidence interval [CI], 11.8-54.2%). CAB therapy obtained a partial response in 2 of the 13 (15.3%) evaluable patients (95% CI, 2.9-45.4%). Median survival from initiation of CAB was 8.2 (95% CI, 3.34-13.05) months, from AA 16.1 (95% CI, 11.56-20.64) and from docetaxel 32.0 (95% CI, 11.56-39.69).
CONCLUSION: A limited number of patients with mCRPC received CAB after docetaxel and AA treatment. In this selected population, CAB was active.
Written by:
Sella A, Sella T, Peer A, Berger R, Frank SJ, Gez E, Sharide D, Hayat H, Hanovich E, Kovel S, Rosenbaum E, Neiman V, Keizman D. Are you the author?
Department of Oncology, Assaf Harofeh Medical Center, Zerifin, Israel; Department of Oncology, Sheba Medical Center, Ramat Gan, Israel; Department of Oncology, Rambam Health Care Campus, Haifa, Israel; Department of Oncology, Hadassah Medical Center, Jerusalem, Israel; Department of Oncology, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; Department of Oncology, Wolfson Medical Center, Holon, Israel; Department of Oncology, Rabin Medical Center, Petach-Tikva, Israel; Department of Oncology, Meir Medical Center, Kfar-Saba, Israel.
Reference: Clin Genitourin Cancer. 2014 Jun 10. pii: S1558-7673(14)00110-4.
doi: 10.1016/j.clgc.2014.06.007
PubMed Abstract
PMID: 25066221
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