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ESMO 2022: Dosing Adjustments With Cabazitaxel in Older Patients With Prostate Cancer

By: Kayci Reyer
Posted: Monday, September 19, 2022

A lower dose and higher frequency of cabazitaxel treatment may result in comparable survival and clinical outcomes while decreasing the likelihood of experiencing adverse events for some patients with metastatic castration-resistant prostate cancer. These findings, based on data from the randomized phase III CABASTY trial, were presented at the European Society for Medical Oncology (ESMO) Congress 2022 (Abstract 1363MO). Although a higher dose of cabazitaxel has been demonstrated to prolong overall survival, it has also been associated with more severe neutropenia.

“[The every-other-week cabazitaxel] regimen could become a practice-changing therapy for elderly [metastatic castration-resistant prostate cancer] patients,” concluded Stéphane Oudard, MD, PhD, of Hôpital Européen Georges-Pompidou, Paris, and colleagues.

The CABASTY trial randomly assigned 196 patients to receive either 25 mg/m2 of cabazitaxel every 3 weeks (n = 97) or 16 mg /m2 of cabazitaxel every 2 weeks with prednisone and granulocyte colony-stimulating factor. Neutropenia and/or neutropenic complications of at least grade 3 occurred significantly more often in the 3-week group (62.9% vs. 5.1%). Adverse events in general of at least grade 3 were also more common in the higher-dose group (72.9% vs. 58.2%). That group also recorded one death related to neutropenic complication.

Survival outcomes were comparable between the groups. In the 3-week and 2-week groups, respective median overall survival was 14.1 months versus 14.0 months, and respective median progression-free survival was 6.3 months versus 6.7 months. Clinical outcomes were also similar, with an objective tumor response rate of 18.1% in the higher-dose group versus 15.4% in the lower-dose group.

Median patient age was 74 years, and 79.6% of patients were at least 70 years of age. A total of 30.1% of patients were considered vulnerable or frail. Most patients (86.7%) had previously received treatment with an alternative androgen-targeted agent.

Disclosure: For full disclosures of the study authors, visit

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