Interim safety analysis of a compassionate-use program (CUP) and early-access program (EAP) providing cabazitaxel (Cbz) plus prednisone (P) to patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) previously treated with docetaxel.

Authors

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Zafar I. Malik

Clatterbridge Cancer Centre, Merseyside, United Kingdom

Zafar I. Malik , Giuseppe Di Lorenzo , Mert Basaran , Alexandros Ardavanis , Phillip Parente , Wito de Schultz , Fred Saad , Inge van Oort , Winald R. Gerritsen , Luis M. Antón Aparicio , Geoffrey Matus , Simon Hitier , Axel Heidenreich , Amit Bahl

Organizations

Clatterbridge Cancer Centre, Merseyside, United Kingdom, GU Cancer Section, University Federico II, Naples, Italy, Institute of Oncology, Istanbul University, Istanbul, Turkey, St. Savas Anticancer Hospital, Athens, Greece, Eastern Health Clinical School, Box Hill Hospital, Monash University, Melbourne, Australia, Klinik für Urologie, Asklepios Klinik, Weissenfels, Germany, University of Montreal Hospital Center, CRCHUM, Montreal, QC, Canada, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands, Medical Oncology Service, CHU A Coruña, A Coruña, Spain, Centre Hospitalier Chrétien-Liège, Clinique Saint-Joseph, Liège, Belgium, Sanofi, Chilly-Mazarin, France, University Hospital Aachen, Aachen, Germany, Bristol Haematology and Oncology Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom

Research Funding

Pharmaceutical/Biotech Company

Background: Cbz + P provides a significant survival benefit vs mitoxantrone + P in pts with mCRPC (Phase III TROPIC study [NCT00417079]; hazard ratio 0.70; p < 0.0001). These findings supported the initiation of ongoing Sanofi-funded CUP and EAP (NCT01254279) to provide access to Cbz prior to commercialization and to collect real-life safety data. Methods: Expected enrollment is ~1600 pts with mCRPC from 250 centers worldwide. Pts receive Cbz (25 mg/m2 Q3W) + P (10 mg oral QD) until progressive disease (PD), death, unacceptable toxicity, physician/pt decision or Cbz commercial availability. Pts are followed until 30 days after last dose. Granulocyte colony-stimulating factor (G-CSF) use is recommended as per ASCO guidance. Results: Interim baseline and safety data from the first 1301 pts treated in 37 countries are now available. Mean age was 68 yrs (22% were ≥ 75 yrs). All pts had an ECOG performance status ≤ 2. Median time from initial prostate cancer diagnosis was 57.6 months and 60% of pts had ≥ 2 metastatic sites; the most common were bone (91%) and lymph nodes (regional 30%, distant 27%). In total, 17% had PD whilst on docetaxel. The median number of Cbz cycles was 6 (range 1–22); median relative dose intensity was 99%. Overall, 837 pts (64%) received G-CSF (n = 123 curative [C], n = 765 prophylactic [P] and n = 99 [C + P]). Of 1142 pts (88%) who discontinued Cbz + P, the most common reasons were PD (44%), adverse event (AE; 27%), physician decision (13%) and commercial availability of Cbz (7%). Grade 3–4 AEs possibly related to Cbz + P occurred in 43% of pts; the most frequent were clinical neutropenia (18%), febrile neutropenia (FN; 7%) and diarrhea (4%). Of 80 pts (6%) with AEs leading to death, the AE was related to Cbz + P in 39 pts (3%). Conclusions: These results provide valuable data on Cbz + P treatment in routine clinical practice, confirming the safety results of clinical trials and showing that treatment with Cbz + P is associated with a manageable safety profile. The incidence of FN seems slightly lower than in TROPIC, owing to more frequent use of G-CSF prophylaxis in the CUP and EAP. Clinical trial information: NCT01254279.

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Abstract Details

Meeting

2013 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Genitourinary (Prostate) Cancer

Track

Genitourinary Cancer

Sub Track

Prostate Cancer

Clinical Trial Registration Number

NCT01254279

Citation

J Clin Oncol 31, 2013 (suppl; abstr 5055)

DOI

10.1200/jco.2013.31.15_suppl.5055

Abstract #

5055

Poster Bd #

37F

Abstract Disclosures