Jevtana carboplatin for prostate cancer – pro
While Jevtana is FDA approved for prostate cancer, adding carboplatin is based on a single recently presented phase II study Adding carboplatin to cabazitaxel was safe and associated with improved progression-free survival (PFS) among men with castration-resistant prostate cancer (CRPC), and particularly men with aggressive variant prostate carcinoma (AVPC), according to a randomized phase II trial presented at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting. Analysis and comparison of the data demonstrated that median PFS was significantly longer for patients receiving combination versus single agent chemotherapy (6.7 months vs 4.4 months, respectively, p = 0.01). Furthermore, reductions in both PSA and BAP were greater for the combination therapy group. PSA reductions greater than 50 percent occurred 60 percent of the time with combined chemotherapy vs. 44 percent with the single drug. PSA reductions greater than 90 percent occurred 28 percent of the time with two chemotherapy drugs vs. 20 percent with one. In addition, BAP reductions greater than 50 percent for combination vs. single drug were 63 percent and 25 percent respectively. Side effects, such as fatigue, anemia and neutropenia were comparable for both the single-drug regimen and two-drug regimen.
A phase III study is being launched., In the meantime, the combination is not recommended by guidelines or, to my knowledge, by AHFS, DrugDex or NCCN.
NCCN, Prostate 2016
Paul Gettys Corn, Shi-Ming Tu, Amado J. Zurita, Sumit Kumar Subudhi, John C. Araujo, Jeri Kim, Eric Jonasch, Lance C. Pagliaro, Arlene O. Siefker-Radtke, Jennifer Wang, Xuemei Wang, Elisabeth I. Heath, Christopher Logothetis and Ana Aparicio, A multi-institutional randomized phase II study (NCT01505868) of cabazitaxel (CAB) plus or minus carboplatin (CARB) in men with
metastatic castration-resistant prostate cancer (mCRPC).Journal of Clinical Oncology, 2015 ASCO Annual Meeting (May 29 – June 2, 2015). Vol 33, No 15_suppl (May 20 Supplement), 2015: 5010