Survival With Cabazitaxel in Metastatic Castration-Resistant Prostate Cancer in Clinical Practice

[Balsam01]

TAKE-HOME MESSAGE

•This cohort study was designed to evaluate real-world outcomes associated with the use of cabazitaxel for patients with metastatic castration-resistant prostate cancer. The median duration of treatment with cabazitaxel was 3.4 months. Median overall survival was 11.9 months, and this was shorter than has been observed in clinical trials.

•Overall survival with cabazitaxel in a real-world cohort of patients with metastatic castration-resistant prostate cancer was shorter than previously reported in clinical trials.

– Neil Majithia, MD

BACKGROUND

Cabazitaxel is a treatment of metastatic castration-resistant prostate cancer (mCRPC) after docetaxel failure. The FUJI cohort aimed to confirm the real-life overall and progression-free survival (OS, PFS) and safety of cabazitaxel.

METHODS

Multicentre, non-interventional cohort of French mCRPC patients initiating cabazitaxel between 2013 and 2015, followed 18 months.

RESULTS

Four hundred one patients were recruited in 42 centres. At inclusion, median age was 70, main metastatic sites were bones (87%), lymph nodes (42%) and visceral (20%). 18% had cabazitaxel in 2nd-line treatment, 39% in 3rd-line and 43% in 4th-line or beyond. All had prior docetaxel, and 82% prior abiraterone, enzalutamide or both. Median duration of cabazitaxel treatment was 3.4 months. Median OS from cabazitaxel initiation was 11.9 months [95% CI: 10.1-12.9]. In multivariate analyses, grade ≥ 3 adverse events, visceral metastases, polymedication, and >5 bone metastases were associated with a shorter OS. Main grade ≥ 3 adverse events were haematological with 8% febrile neutropenia.

CONCLUSION

Real-life survival with cabazitaxel in FUJI was shorter than in TROPIC (pivotal trial, median OS 15.1 months) or PROSELICA (clinical trial 20 vs 25 mg/m2, median OS, respectively, 13.4 and 14.5 months). There was no effect of treatment-line on survival. No unexpected adverse concerns were identified.

British Journal of Cancer

Overall and Progression-Free Survival With Cabazitaxel in Metastatic Castration-Resistant Prostate Cancer in Routine Clinical Practice: The FUJI Cohort

Br. J. Cancer 2019 Nov 13;[EPub Ahead of Print], M Rouyer, S Oudard, F Joly, K Fizazi, F Tubach, J Jove, C Lacueille, S Lamarque, E Guiard, A Balestra, C Droz-Perroteau, A Fourrier-Reglat, N Moore

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

[Bjry]

Just a guess but the difference may arise because in clinical trials they usually impose all sorts of patient exclusions eg because some might have serious but unrelated medical conditions. whereas in real life we are all counted regardless of our circumstances.