Prostate Cancer Coverage from Every Angle

Cabazitaxel or Androgen Receptor–Targeted Therapies for Metastatic Prostate Cancer

By: Lauren Harrison, MS
Posted: Monday, November 18, 2019

According to findings from the CARD trial, cabazitaxel improved patient outcomes such as radiographic progression-free survival and overall survival when compared with androgen receptor–targeted therapies for patients with metastatic castration-resistant prostate cancer. Ronald de Wit, MD, PhD, of the Erasmus MC Cancer Institute in the Netherlands, presented these findings at the European Society for Medical Oncology (ESMO) Congress 2019 (Abstract LBA13).

The trial recruited 255 patients with metastatic prostate cancer who had been previously treated with at least three cycles of docetaxel and experienced disease progression within 12 months on an alternative androgen receptor–targeted therapy. Patients were randomly assigned to receive cabazitaxel or either one of the androgen receptor–targeted therapies abiraterone or enzalutamide. Patients were treated with cabazitaxel for a median of 7 weeks and androgen receptor–targeted therapies for a median of 4 weeks.

The radiographic progression-free survival was improved with cabazitaxel treatment, with a median of 8.0 months versus 3.7 months with abiraterone or enzalutamide (hazard ratio = 0.54). Overall survival was also improved with cabazitaxel compared with the androgen receptor–targeted therapies (13.6 months and 11.0 months, respectively). The confirmed PSA50 response rates were 35.7% in the group assigned to cabazitaxel and 13.5% in the abiraterone and enzalutamide groups. Pain response as well as time to symptomatic skeletal events were improved with cabazitaxel as well.

Grade 3 or higher adverse events occurred in 56.3% of patients taking cabazitaxel and 52.4% of patients on the androgen receptor–targeted therapies. Common grade 3 or higher adverse events in the cabazitaxel and abiraterone/enzalutamide groups included renal disorders (3.2% vs. 8.1%); infections (7.9% vs. 7.3%); musculoskeletal pain (1.6% vs. 5.6%); cardiac disorders (0.8% vs. 4.8%); spinal cord disorders (2.4% vs. 4.0%); fatigue (4.0% vs 2.4%); and diarrhea, peripheral neuropathy, and febrile neutropenia (3.2% vs. 0% each).

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