Bristol Haematology and Oncology Centre, Bristol, United Kingdom
Amit Bahl , Susan Masson , Zafar I. Malik , Alison J. Birtle , Santhanam Sundar , Robert J. Jones , Nicholas David James , Malcolm David Mason , David Bottomley , Anna Lydon , Simon Chowdhury , James Wylie , Johann Sebastian De Bono
Background: Several drugs can now improve survival in mCRPC after docetaxel, including cabazitaxel, a next generation taxane. TROPIC (NCT00417079) showed an overall survival benefit of 2.4 months for cabazitaxel compared with mitoxantrone for mCRPC. The UK EAP provided patients access to cabazitaxel; detailed QOL and safety data were recorded. Interim analysis suggested improvements in QOL, particularly pain scores and a good safety profile. We report final QOL and updated safety data. Methods: 108 patients recruited at 12 centres received cabazitaxel 25mg/m2intravenously every 3 weeks with oral prednisolone 10mg daily. EQ-5D questionnaires and health state visual analogue scale (VAS) were completed at baseline, at alternate cycles and at 30 days post treatment. Safety assessments followed each cycle. Results: According to EQ-5D and VAS scores, QOL was stable with an overall trend towards improvement in patients who continued treatment. Paired ‘within patient’ analyses also support this trend. Improved pain was noted more frequently than deterioration at all time points and pain scores were at least stable in 96% of patients at cycle 10. A median of 6 cycles were given. 34 patients (31%) received 10 or more cycles. Grade 3/4 adverse events were uncommon, the most frequent being fatigue (9.3%), diarrhoea (2.8%) and neutropenic sepsis (1.9%). 85% received prophylactic granulocyte colony stimulating factor. Conclusions: Almost 1/3 of patients completed 10 or more cycles in the UK EAP. QOL was stable with trends to improved EQ-5D and VAS scores. Improved or stable pain was observed in the majority of patients continuing therapy. The UK EAP provides the first data on QOL benefit with cabazitaxel in mCRPC post docetaxel and demonstrates manageable toxicity. Final safety data will be available for presentation. Clinical trial information: NCT01254279.
N | Mean score range 0-1 |
|
---|---|---|
Baseline | 100 | 0.698 (0.654 - 0.741) |
Cycle 2 | 97 | 0.730 (0.689 - 0.770) |
Cycle 4 | 74 | 0.765 (0.719 - 0.812) |
Cycle 6 | 63 | 0.761 (0.716 - 0.805) |
Cycle 8 | 37 | 0.781 (0.711 - 0.851) |
Cycle 10 | 28 | 0.817 (0.743 - 0.891) |
Post treatment | 62 | 0.695 (0.633 - 0.756) |
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