J Cancer 2017; 8(4):507-512. doi:10.7150/jca.17644 This issue Cite
Research Paper
1. Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany;
2. Department of Urology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany;
3. Onkologische Schwerpunktpraxis Heidelberg, Kurfürstenanlage 34, 69115 Heidelberg, Germany;
4. Department of Urology, Klinikum Nürnberg, Paracelsus Medical University, Prof.-Ernst-Nathan-Str. 1, 90419 Nürnberg, Germany;
5. Section of Molecular Urooncology, Department of Urology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
Purpose: Several new treatment options for patients with metastatic castration resistant prostate cancer (mCRPC) have been approved within the last years - among them cabazitaxel (CAB), abiraterone acetate, enzalutamide, and radium-223. The aim of this study was to assess factors predictive for efficacy of CAB.
Methods: We analyzed all patients with mCRPC treated with CAB at our institutions between 2011 and 2016. Data were retrieved retrospectively from the electronical patient chart.
Results: 69 patients received CAB (26.1% 2nd line, 36.2% 3rd line, 37.3% >3rd line). Median overall survival (OS) on CAB was 10.0 months (95%CI 7.1-12.9). Median progression free survival (PFS) on CAB was 3.9 months (95%CI 3.0-4.8). There were no differences in OS and PFS regarding treatment line of CAB (2nd vs. higher; 2nd/3rd vs. higher). Duration of remission on 1st line treatment (> 6 months vs. </= 6 months) was associated with a longer PFS with subsequent CAB treatment (4.1 months vs. 3.0 months (95%CI 3.0-5.2; 2.2-3.8); p=0.021). Patients with visceral metastases had a shorter PFS (3.0 months; 95%CI 2.6-3.3) and OS (8.7 months; 95%CI 5.9-11.5) on CAB compared to patients who had bone and/or lymph node lesions only (PFS: 5.8 months; 95%CI 3.2-8.4; p=0.014; OS: 11.7 months; 95%CI 7.5-15.9; p=0.042).
Conclusions: Results from our patient cohort suggest that a longer PFS to any 1st line treatment for mCRPC is correlated with a longer PFS to CAB for any later line treatment. Patients with nodal and bone metastases only had a significantly superior PFS and OS with CAB treatment than patients with visceral metastases.
Keywords: Cabazitaxel, prostate cancer, sequencing therapy, survival, castration resistance.