carboplatin and cabazitaxel for refractory prostate cancer – pro
The combination of carboplatin and cabazitaxel for refractory prostate cancer patients was recenlty investigated and presented at the 2014 ASCO meeting. Activity was noted but there were only 9 patients. Updated results were rpesented in 2016 ASCO. A total of 160 men with metastatic CRPC were enrolled in the study between 2013 and 2015, and were randomly assigned 1:1 to receive cabazitaxel (25 mg/m2) with or without carboplatin (AUC, 4) every 21 days. The men were stratified based on clinically defined AVPC..At a median follow-up of 21.6 months, median PFS in the overall population was 7.4 months in the cabazitaxel + carboplatin group vs 4.59 months in the cabazitaxel-only group (P = .004). A subsequent subgroup analysis showed that carboplatin-associated improvement in median PFS remained statistically significant among men with clinically defined AVPC (5.64 months in the cabazitaxel + carboplatin group vs 3.75 months in the cabazitaxel-only group; P = .012), but not among men with non-AVPC metastatic CRPC (7.8 months vs 5.2 months; P = .09).
Common adverse events included fatigue, nausea, vomiting, dyspnea, and constipation. Three cases of grade 4 thrombocytopenia and seven cases of grade 4 neutropenia occurred in the cabazitaxel + carboplatin group, vs one and no such cases, respectively, in the cabazitaxel-only group.
“Additional analyses are ongoing to test the candidate AVPC-m signature in these samples, as well as the rate of alterations in other pathways (eg, DNA damage repair),” the authors wrote. They plan a phase III study with overall survival as the primary endpoint.
Until pahse III results are available, this remains an experimental treatment.
aul Gettys Corn, Shi-Ming Tu, Amado J. Zurita, John C. Araujo, Lance C. Pagliaro, Christopher Logothetis, Ana Aparicio; The University of Texas MD Anderson Cancer Center, Houston, TX,
A randomized phase I/II study to examine the contribution of carboplatin to cabazitaxel for the treatment of men with metastatic castration-resistant prostate cancer (mCRPC) with and without anaplastic features. J Clin Oncol 32, 2014 (suppl 4; abstr 148)
http://www.cancernetwork.com/asco-2016-prostate-cancer/adding-carboplatin-cabazitaxel-improves-pfs-aggressive-variant-crpc
NCCN. Prostate 2016