The efficacy and toxicity of cabazitaxel for treatment of docetaxel-resistant prostate cancer correlating with the initial doses in Japanese patients

• Terada, Naoki

• Kamoto, Toshiyuki

• Tsukino, Hiromasa

• Mukai, Shoichiro

• Akamatsu, Shusuke

• Inoue, Takahiro

• Ogawa, Osamu

• Narita, Shintaro

• Habuchi, Tomonori

• Yamashita, Shinichi

• Mitsuzuka, Koji

• Arai, Yoichi

• Kandori, Shuya

• Kojima, Takahiro

• Nishiyama, Hiroyuki

• Kawamura, Yoshiaki

• Shimizu, Yuki

• Terachi, Toshiro

• Sugi, Motohiko

• Kinoshita, Hidefumi

• Matsuda, Tadashi

• Yamada, Yusuke

• Yamamoto, Shingo

• Hirama, Hiromi

• Sugimoto, Mikio

• Kakehi, Yoshiyuki

• Sakurai, Toshihiko

• Tsuchiya, Norihiko

Abstract

Background: We analyzed the efficacy and toxicity of cabazitaxel (CBZ) at high and low initial doses in Japanese patients with docetaxel-resistant castration-resistant prostate cancer (CRPC). Methods: We retrospectively evaluated 118 patients who received CBZ for docetaxel-resistant CRPC in 10 university hospitals in Japan between 2014 and 2016. The rate of decrease of prostate-specific antigen (PSA), adverse events, progression-free survival (PFS), and overall survival (OS) were compared between patients receiving initially high (≥22.5 mg/m2, n = 36) and low (≤20 mg/m2, n = 80) CBZ doses. Factors associated with survival and grade 4 neutropenia were evaluated. Results: PSA values decreased by > 50% in 22 patients (19%), with a higher frequency in the high-dose group than in the low-dose group (29 and 14%, P = 0.073). The median PFS time for the all-patient, high- and low-dose groups was 2.8 months (95% confidence interval [CI] 1.9–4.4), 2.1 months (1.2–5.5), and 3.0 months (2.0–4.4), respectively (P = 0.904). The median OS times were 16.3 months (95% CI 9.7–30.9), 30.9 months (11.8–47.4), and 10.2 months (8.6–20), respectively (P = 0.020). In multivariate analyses, PFS was significantly associated with existing bone metastasis at diagnosis (P = 0.005) and OS with PSA > 100 ng/ml (P = 0.007), hemoglobin < 12 g/dl (P = 0.030), and low initial CBZ dose (P = 0.030). Grade 4 neutropenia occurred in 53 patients (45%) and was associated with a low CBZ dose (hazard ratio 0.21, 95% CI 0.08–0.59, P = 0.002). Conclusions: CBZ at a higher initial dose may have similar response rate and response duration, but longer survival duration after treatment with higher toxicity than a lower initial dose for docetaxel-resistant CRPC in Japanese patients.

Journal

• BMC Cancer

  BMC Cancer 19 156-, 2019-02-15

  Springer Nature

Keywords

• Prostate cancer
• Cabazitaxel
• Dosage
• Efficacy
• Toxicity
• Predictive factors

Details

• CRID: 1050001338413815808
• NII Article ID: 120006709422
• ISSN: 14712407
• ISSN: http://id.crossref.org/issn/14712407
• DOI: 10.1186/s12885-019-5342-9
• HANDLE: 2433/243234
• Web Site: http://link.springer.com/content/pdf/10.1186/s12885-019-5342-9.pdf
• Web Site: http://link.springer.com/article/10.1186/s12885-019-5342-9/fulltext.html
• Text Lang: en
• Article Type: journal article
• Data Source:
  • IRDB
  • Crossref
  • CiNii Articles
  • KAKEN