Abstract
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.
Keywords
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Article info
Publication history
Published online: June 10, 2014
Accepted:
June 3,
2014
Received in revised form:
April 30,
2014
Received:
January 3,
2014
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
