https://orcid.org/0000-0001-6251-622X
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Abstract
Cabazitaxel (25mg/m2 every 3 weeks) is the standard second-line chemotherapy for patients with metastatic castration-resistant prostate cancer previously treated with docetaxel. It is associated with a risk of neutropenic complications, which may be a barrier to its use in daily clinical practice, particularly in frail elderly patients. Here the authors reviewed key studies conducted with cabazitaxel (TROPIC, PROSELICA, AFFINITY, CARD and the European compassionate use program) and pilot studies with adapted schedules. Based on this review, the use of prophylactic granulocyte colony-stimulating factor from cycle 1 appears crucial to maximize the benefit-risk ratio of cabazitaxel in metastatic castration-resistant prostate cancer. Preliminary data with alternative schedules look promising, especially for frail patients. Results of the ongoing Phase III CABASTY trial (ClinicalTrials.gov: NCT02961257) are awaited.
Lay abstract
Cabazitaxel is a type of chemotherapy used to treated patients with advanced prostate cancer. Its toxicity to white blood cells could lead to infectious complications, particularly in frail elderly patients. In this article, the authors reviewed important clinical trials regarding cabazitaxel and adapted schedules. Based on this review, white blood cell–stimulating agents appear crucial to maximize the benefit-risk ratio of cabazitaxel in advanced prostate cancer. Alternative schedules look promising, especially for frail patients. Results of the ongoing Phase III CABASTY trial (ClinicalTrials.gov: NCT02961257) are awaited.
Author contributions
All authors participated in the writing of the article.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents, received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.