Efficacy of cabazitaxel in patients with metastatic castration‐resistant prostate cancer: A single‐center study in Japan. (28th September 2022)

• Record Type: Journal Article
• Authors: Yamamoto, Yoshiyuki; Ishii, Makoto; Yoshimura, Akihiro; Hayashi, Takuji; Kawamura, Norihiko; Nagahara, Akira; Nakai, Yasutomo; Nakayama, Masashi; Kakimoto, Ken‐ichi; Nishimura, Kazuo
• Is Part Of: International journal of urology. Volume 30:Number 1(2023)
• Page Start: 20
• Page End: 27
• Publication Date: 2022-09-28
• Subjects: cabazitaxel -- castration‐resistant prostate cancer -- hemoglobin -- overall survival -- prognosis; Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/iju.15052
• Languages: English
• ISSNs: 0919-8172

Abstract

Abstract : Objectives: Cabazitaxel is a next‐generation taxane that can prolong overall survival after docetaxel treatment in patients with metastatic castration‐resistant prostate cancer. However, the efficacy of cabazitaxel varies among these patients. The clinical indicators of the prognosis after cabazitaxel treatment were analyzed. Methods: A retrospective review of patients who received cabazitaxel between February 2015 and June 2021 was performed. All patients had metastatic castration‐resistant prostate cancer. Prognostic factors for prostate‐specific antigen progression‐free and overall survival were analyzed by Cox proportional‐hazards analysis and the log‐rank test. Results: The study comprised 57 patients who received cabazitaxel (median 4 cycles, range 1–27) at a starting dose of 15–25 mg/m 2 . The median age and follow‐up duration were 70 years and 9.2 months. The median prostate‐specific antigen progression‐free survival and overall survival were 2.6 and 10.5 months, respectively. Univariate analysis showed that previous androgen receptor‐axis‐targeted therapy before cabazitaxel treatment was the only significant risk factor (hazard ratio 2.784, p = 0.022) for prostate‐specific antigen progression‐free survival. Multivariate analysis for overall survival revealed that poor performance status (≥1) (hazard ratio 2.107, p = 0.039), low hemoglobin (hazard ratio 0.142, p = 0.010), and high neutrophil‐lymphocyte ratio (hazard ratio 9.150, p = 0.032) at baseline were significantly associated with a poor prognosis. Conclusions: Previous androgen receptor‐axis‐targeted therapy was the only risk factor for biochemical progression. Poor performance status, anemia, and high neutrophil‐lymphocyte ratio were risk factors for poor prognosis in patients with metastatic castration‐resistant prostate cancer treated with cabazitaxel. These risk factors seem useful for identifying patients with survival benefit from cabazitaxel treatment.