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Cabazitaxel (Jevtana) more than once for castrate resistant prostate cancer


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Jim Marshall (not a doctor) said ...

If you have castrate-resistant prostate cancer, common treatments that your doctor may add to your regular ADT treatment include:

  • Docetaxel (Taxotere)
  • Enzalutamide (Xtandi) or Abiraterone (Zytiga)
  • Cabazitaxel (Jevtana).

But what are your doctor's drug choices when the cancer is no longer under control after all three options?

If you responded to docetaxel, your doctor knows you may well respond again to another dosing of docetaxel.

But this increases your risk of side effects - especially peripheral neuropathy or nail disorders.

Thibault and her colleagues looked at the possibility of giving cabazitaxel another go. They report a benefit to men - 34.3% improved, and 47.8% remained stable.

 

Peripheral neuropathy: nerve damage to hands and feet.

Castrate-resistant prostate cancer: PSA going up, even though testosterone is very low.

... end Jim

 

The full article can be found in the European Journal of Cancer 2018: http://www.ejcancer.com/article/S0959-8049(18)30725-1/fulltext

which reported the following Results and Conclusions:

Results

A total of 69 of 562 patients (Eastern Cooperative Oncology Group performance status 0–1 69%) were rechallenged with CABA (25 mg/m2 q3w, 58%; 20 mg/m2 q3w, 27.5%; other, 14.5%) for 1–10 (median 6) cycles; 76.8% received prophylactic granulocyte colony-stimulating factor. Median radiological or clinical PFS with CABA rechallenge was 7.8 months and 11.9 months with initial CABA therapy. OS was 13.7 months (95% confidence interval [CI]: 9.3–15.7) from the first CABA rechallenge cycle, 59.9 months (47.8–67.1) from the first life-extending therapy in mCRPC and 78.3 months (66.4–90.7) from mCRPC diagnosis. Best clinical benefit was improved (34.3%) or stable (47.8%). Lack of response to rechallenge occurred in 17.9% of patients (3.1% with initial CABA). The level of prostate-specific antigen decreased by ≥ 50% in 24% of patients at rechallenge (71% with initial CABA). There was no grade ≥III peripheral neuropathy or nail disorders.

Conclusions

CABA rechallenge may be a treatment option without cumulative toxicity in heavily pretreated patients with mCRPC who are still fit and had a progression >3 months after the last CABA injections.

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