Effectiveness and safety of cabazitaxel plus prednisolone chemotherapy for metastatic castration-resistant prostatic carcinoma: data on Korean patients obtained by the cabazitaxel compassionate-use program

Abstract

Purpose To report the efficacy and safety of using cabazitaxel plus prednisolone chemotherapy to treat Korean patients with metastatic castration-resistant prostate cancer (mCRPC) following docetaxel therapy.

Methods This cohort study enrolled 26 mCRPC patients. Treatment consisted of 25 mg/m2 cabazitaxel that was intravenously administered every 3 weeks, in addition to twice-daily 5 mg prednisolone.

Results The median patient age was 67 years (range = 53–82), median Eastern Cooperative Oncology Group performance status was 1 (range = 0–2), Gleason score was ≥8 in 25 patients (96 %), and median serum prostate-specific antigen (PSA) was 95.3 ng/mL (interquartile range = 9.1–297.7). A total of 180 treatment cycles were administered, and a median of five cycles were administered per patient (range = 1–23). A PSA response was observed in 32 % of evaluable patients. Tumor response was evaluated in eight patients, and three and four patients achieved partial response and stable disease, respectively. Over a median follow-up duration of 23.4 months (95 % CI 11.1–35.6), median time to treatment failure was 4.2 months (95 % CI 1.8–6.6) and median time to progression was 8.5 months (95 % CI 3.0–13.1). Median overall survival was 16.5 months (95 % CI 12.1–20.9). Grade 3 or worse febrile neutropenia developed in eight patients (31 %) and neutropenic infection in four patients (15 %).

Conclusion Cabazitaxel plus prednisolone chemotherapy can be used to treat Korean mCRPC patients. Prophylactic growth factor support should be considered for patients at high risk of neutropenic fever or infection.