Article of the Month: Cabazitaxel Improves QoL in mCRPC

Every Month the Editor-in-Chief selects an Article of the Month from the current issue of BJUI. The abstract is reproduced below and you can click on the button to read the full article, which is freely available to all readers for at least 30 days from the time of this post.

In addition to the article itself, there is an accompanying editorial written by a prominent member of the urological community. This blog is intended to provoke comment and discussion and we invite you to use the comment tools at the bottom of each post to join the conversation.

If you only have time to read one article this week, it should be this one.

Final Quality of Life and Safety Data for patients with mCRPC treated with Cabazitaxel in the UK Early Access Programme (NCT01254279)

Amit Bahl*, Susan Masson*, Zafar Malik†, Alison J. Birtle‡, Santhanam Sundar§, Rob J. Jones¶, Nicholas D. James**, Malcolm D. Mason††, Satish Kumar††, David Bottomley‡‡, Anna Lydon§§, Simon Chowdhury¶¶, James Wylie*** and Johann S. de Bono†††

*Bristol Haematology and Oncology Centre, Bristol, †Clatterbridge Centre for Oncology, Wirral, ‡Rosemere Cancer Centre, Royal Preston Hospital, Preston, §Nottingham University Hospitals NHS Trust, Nottingham, ¶University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, **School of Cancer Sciences, University of Birmingham, Birmingham, ††Velindre Hospital, Cardiff, ‡‡St James’s University Hospital, Leeds, §§South Devon Healthcare NHS Foundation Trust, Torquay, ¶¶Guy’s and St. Thomas’ NHS Foundation Trust, London, ***The Christie NHS Foundationm Trust, Manchester, and †††The Institute for Cancer Research and Royal Marsden Hospital, Sutton, UK

Read the full article

OBJECTIVE

To compile the safety profile and quality of life (QoL) data for patients with metastatic castration-resistant prostate cancer (mCRPC) treated with cabazitaxel in the UK Early Access Programme (UK EAP).

PATIENTS AND METHODS

A total of 112 patients participated at 12 UK cancer centres. All had mCRPC with disease progression during or after docetaxel. Patients received cabazitaxel 25 mg/m² every 3 weeks with prednisolone 10 mg daily for up to 10 cycles. Safety assessments were performed before each cycle and QoL was recorded at alternate cycles using the EQ-5D-3L questionnaire and visual analogue scale (VAS). Thesafety profile was compiled after completion of the UK EAP and QoL measures were analysed to record trends. No formal statistical analysis was carried out.

RESULTS

The incidences of neutropenic sepsis (6.3%), grade 3 and 4 diarrhoea (4.5%) and grade 3 and 4 cardiac toxicity (0%) were low. Neutropenic sepsis episodes, though low, occurred only in patients who did not receive prophylactic granulocyte-colony stimulating factor. There were trends towards improved VAS and EQ-5D-3L pain scores during treatment.

CONCLUSIONS

The UK EAP experience indicates that cabazitaxel might improve QoL in mCRPC and represents an advance and a useful addition to the armamentarium of treatment for patients whose disease has progressed during or after docetaxel. In view of the potential toxicity, careful patient selection is important.