Cabazitaxel Impacts Sequencing Strategies in Prostate Cancer

May 7, 2020
Daniel George, MD

Daniel J. George, MD, discusses how cabazitaxel can impact the sequencing approaches physicians use to treat patients with metastatic castration-resistant prostate cancer.

Daniel J. George, MD, professor of medicine and surgery, member, Duke Cancer Institute, discusses how cabazitaxel (Jevtana) can impact the sequencing approaches physicians use to treat patients with metastatic castration-resistant prostate cancer.

According to George, there are 2 things to think about when using cabazitaxel in this treatment landscape that may make this agent ideal for sequencing. First is the tolerability of the agent. When it was first developed in clinical trials, it showed survival benefit at a dose of 25 mg/m2. However, there was also an association between the drug and significant neutropenia and diarrhea in some patients. In a head to head comparison study of a 20 mg/m2 dose versus the 25 mg/m2 dose, cabazitaxel demonstrated no decrease in efficacy but a decrease in the rates of these common toxicities, particularly neutropenia, George says.

The second strategy George highlights is that this is a novel taxane that has demonstrated survival benefit and efficacy after treatment with docetaxel. We know there are some differences in these drugs, George says, and it is possible that the tolerance and efficacy may prove to be optimal for this type of sequencing.

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