The influence of prior novel androgen receptor targeted therapy on the efficacy of cabazitaxel in men with metastatic castration-resistant prostate cancer.
BACKGROUND
The treatment armamentarium for metastatic castration-resistant prostate cancer (mCRPC) has expanded with the introduction of several new therapies. In this treatment continuum, it is unclear whether the efficacy of cabazitaxel is affected by prior novel androgen receptor targeted therapies (ART) such as abiraterone and enzalutamide. In this study, we investigated the influence of prior ART on the efficacy of cabazitaxel in men with mCRPC.


METHODS
Data from an ongoing multicentre, phase II trial were used comprising 114 men with mCRPC treated with cabazitaxel in the post-docetaxel setting. The primary endpoints of the current analysis were prostate-specific antigen (PSA) response (⩾ 50%), and overall survival (OS). Univariate and multivariable analyses were conducted to investigate the influence of prior ART on the efficacy of cabazitaxel.


RESULTS
From the 114 patients included in this analysis, 44 men received prior ART and 70 men did not receive prior ART before treatment with cabazitaxel. PSA response rates while on cabazitaxel treatment were similar in patients with and without prior ART (34% versus 40%, respectively, P = 0.53). Likewise, median OS was not significantly different between men with and without prior ART (13.0 versus 14.0 months, respectively, logrank P = 0.65). In multivariable analysis, the only variables significantly associated with OS were performance status, serum albumin and alkaline phosphatase.


CONCLUSIONS
Our study showed that prior treatment with ART may not influence the efficacy of cabazitaxel in men with mCRPC. With emerging evidence of cross-resistance in the treatment of mCRPC, cabazitaxel provides a good treatment option irrespective of prior ART.
Department of Urology, Erasmus University Medical Center and Cancer Institute, Rotterdam, The Netherlands. Electronic address: r.vansoest@erasmusmc.nl.
R J
RJ
van Soest
Department of Medical Oncology, Erasmus University Medical Center and Cancer Institute, Rotterdam, The Netherlands.
A J M
AJ
Nieuweboer
Department of Urology, Erasmus University Medical Center and Cancer Institute, Rotterdam, The Netherlands.
E S
ES
de Morrée
Department of Biostatistics, Erasmus University Medical Center and Cancer Institute, Rotterdam, The Netherlands.
D
D
Chitu
Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
A M
AM
Bergman
Department of Internal Medicine, Tweesteden Hospital, Tilburg, The Netherlands.
S H
SH
Goey
Department of Internal Medicine, Reinier de Graaf Hospital, Delft, The Netherlands.
M M
MM
Bos
Department of Clinical Trial Center, Erasmus University Medical Center and Cancer Institute, Rotterdam, The Netherlands.
N
N
van der Meer
Department of Internal Medicine, St Franciscus Gasthuis and Prostate Cancer Center, Rotterdam, The Netherlands.
P
P
Hamberg
Department of Medical Oncology, Erasmus University Medical Center and Cancer Institute, Rotterdam, The Netherlands.
R
R
de Wit
Department of Medical Oncology, Erasmus University Medical Center and Cancer Institute, Rotterdam, The Netherlands.
R H J
RH
Mathijssen
D000368:Aged; D000369:Aged, 80 and over; D000736:Androstenes / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001549:Benzamides; D018572:Disease-Free Survival; D000077143:Docetaxel; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000379:methods*; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009570:Nitriles; D010669:Phenylthiohydantoin / Q000008:administration & dosage / Q000031:analogs & derivatives; D017430:Prostate-Specific Antigen / Q000097:blood; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D011944:Receptors, Androgen / Q000378:metabolism*; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome
C410798:AR protein, human; D000736:Androstenes; D001549:Benzamides; D009570:Nitriles; D011944:Receptors, Androgen; D043823:Taxoids; D000077143:Docetaxel; D010669:Phenylthiohydantoin; C552428:cabazitaxel; C540278:enzalutamide; D017430:Prostate-Specific Antigen; C089740:abiraterone
Abiraterone; Cabazitaxel; Enzalutamide; Metastatic castration-resistant prostate cancer; Taxanes