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

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

BMC Cancer

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

• Naoki Terada,
• Toshiyuki Kamoto,
• Hiromasa Tsukino,
• Shoichiro Mukai,
• Shusuke Akamatsu,
• Takahiro Inoue,
• Osamu Ogawa,
• Shintaro Narita,
• Tomonori Habuchi,
• Shinichi Yamashita,
• Koji Mitsuzuka,
• Yoichi Arai,
• Shuya Kandori,
• Takahiro Kojima,
• Hiroyuki Nishiyama,
• Yoshiaki Kawamura,
• Yuki Shimizu,
• Toshiro Terachi,
• Motohiko Sugi,
• Hidefumi Kinoshita,
• Tadashi Matsuda,
• Yusuke Yamada,
• Shingo Yamamoto,
• Hiromi Hirama,
• Mikio Sugimoto,
• Yoshiyuki Kakehi,
• Toshihiko Sakurai and
• Norihiko TsuchiyaEmail author

BMC Cancer201919:156

https://doi.org/10.1186/s12885-019-5342-9

©  The Author(s). 2019

• Received: 19 October 2018
• Accepted: 1 February 2019
• Published: 15 February 2019

Open Peer Review reports

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.

Keywords

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