Efficacy of Cabazitaxel Treatment in Metastatic Castration Resistant Prostate Cancer in Second and Later Lines. An Experience from Two German Centers

Stefanie Zschäbitz; Sonia Vallet; Boris Hadaschik; Daniel Debatin; Stefan Fuxius; Andreas Karcher; Sascha Pahernik; Cathleen Spath; Stefan Duensing; Dirk Jäger; Markus Hohenfellner; Carsten Grüllich

doi:10.7150/jca.17644

Efficacy of Cabazitaxel Treatment in Metastatic Castration Resistant Prostate Cancer in Second and Later Lines. An Experience from Two German Centers

J Cancer. 2017 Feb 11;8(4):507-512. doi: 10.7150/jca.17644. eCollection 2017.

Affiliations

¹ Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany.
² Department of Urology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
³ Onkologische Schwerpunktpraxis Heidelberg, Kurfürstenanlage 34, 69115 Heidelberg, Germany.
⁴ Department of Urology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany;; Department of Urology, Klinikum Nürnberg, Paracelsus Medical University, Prof.-Ernst-Nathan-Str. 1, 90419 Nürnberg, Germany.
⁵ Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany;; Section of Molecular Urooncology, Department of Urology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
⁶ Department of Urology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany;; Section of Molecular Urooncology, Department of Urology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.

Abstract

Purpose: Several new treatment options for patients with metastatic castration resistant prostate cancer (mCRPC) have been approved within the last years - among them cabazitaxel (CAB), abiraterone acetate, enzalutamide, and radium-223. The aim of this study was to assess factors predictive for efficacy of CAB. Methods: We analyzed all patients with mCRPC treated with CAB at our institutions between 2011 and 2016. Data were retrieved retrospectively from the electronical patient chart. Results: 69 patients received CAB (26.1% 2^nd line, 36.2% 3^rd line, 37.3% >3^rd line). Median overall survival (OS) on CAB was 10.0 months (95%CI 7.1-12.9). Median progression free survival (PFS) on CAB was 3.9 months (95%CI 3.0-4.8). There were no differences in OS and PFS regarding treatment line of CAB (2^nd vs. higher; 2^nd/3^rd vs. higher). Duration of remission on 1^st line treatment (> 6 months vs. </= 6 months) was associated with a longer PFS with subsequent CAB treatment (4.1 months vs. 3.0 months (95%CI 3.0-5.2; 2.2-3.8); p=0.021). Patients with visceral metastases had a shorter PFS (3.0 months; 95%CI 2.6-3.3) and OS (8.7 months; 95%CI 5.9-11.5) on CAB compared to patients who had bone and/or lymph node lesions only (PFS: 5.8 months; 95%CI 3.2-8.4; p=0.014; OS: 11.7 months; 95%CI 7.5-15.9; p=0.042). Conclusions: Results from our patient cohort suggest that a longer PFS to any 1^st line treatment for mCRPC is correlated with a longer PFS to CAB for any later line treatment. Patients with nodal and bone metastases only had a significantly superior PFS and OS with CAB treatment than patients with visceral metastases.

Keywords: Cabazitaxel; castration resistance.; prostate cancer; sequencing therapy; survival.