title: Tolerability of cabazitaxel in patients with metastatic castration-resistant prostate cancer progressing after docetaxel and abiraterone acetate: a single-institution experience.
abstract: Both abiraterone acetate (AA) and cabazitaxel (Cbz) have been shown to prolong survival in patients with metastatic castration-resistant prostate cancer (mCRPC) progressing during or after docetaxel (D). Although no standard sequencing has been established as yet, Cbz has recently been proven to be active after AA. However, to date, few data are available on its safety in this setting. Therefore, the primary endpoint of this study was to investigate Cbz tolerability in mCRPC patients treated previously with D and AA. From April 2011 to the present, 43 mCRPC patients received AA after D at our institution. Of these, 22 patients were subsequently treated with Cbz and were evaluable for toxicity in the present retrospective study. Cbz was administered at a dose of 25 mg/m plus 10 mg oral prednisone every 3 weeks. Adverse events (AEs) were reported using the NCI CTCAE (National Cancer Institute Common Terminology Criteria for Adverse Events) version 3.0. Despite the advanced stage of disease and frailty of our study population, there were no unexpected side effects. The most common AEs were hematologic. Neutropenia was observed in nine (40.9%) patients and of grade≥3 in six (27.2%). No febrile neutropenia occurred. The most common nonhematologic AEs were diarrhea and asthenia, reported in eight (36.3%) and in five (22.7%) patients, respectively. In this setting, Cbz toxicity seems to be manageable and comparable with second-line Cbz. Therefore, our results seem to support the safety of Cbz as a third-line treatment for mCRPC patients.
authors.affiliation: aMedical Oncology Unit, Policlinico Umberto I Hospital, University of Rome, Rome bPharmacology Unit cMedical Oncology Unit dUrological and Andrological Unit, Policlinico Santa Maria alle Scotte Hospital, University of Siena, Siena, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Francini
authors.forename: Anna I
authors.initials: AI
authors.lastname: Fiaschi
authors.forename: Roberto
authors.initials: R
authors.lastname: Petrioli
authors.forename: Letizia
authors.initials: L
authors.lastname: Laera
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bianco
authors.forename: Roberto
authors.initials: R
authors.lastname: Ponchietti
authors.forename: Giandomenico
authors.initials: G
authors.lastname: Roviello
mesh_terms: D000368:Aged; D000736:Androstenes / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000077143:Docetaxel; D023381:Endpoint Determination; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects*; D017211:Treatment Failure
chemical_list: D000736:Androstenes; D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel; C552428:cabazitaxel; C089740:abiraterone