Chaya R, Okamura T, Yanase T, Nagai T, Moritoki Y, Kobayashi D, Akita H, Yasui T. Initial treatment outcome and feasibility of low-dose cabazitaxel against docetaxel- and castration-resistant prostate cancer in a Japanese hospital.
J Rural Med 2020;
15:25-28. [PMID:
32015778 PMCID:
PMC6983453 DOI:
10.2185/jrm.2019-004]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 11/01/2019] [Indexed: 11/27/2022] Open
Abstract
Introduction: Cabazitaxel (CBZ) is used worldwide for castration-resistant
prostate cancer after docetaxel treatment. In July 2014 the drug was approved in Japan
with the same induction dose used for Caucasian patients. In this study, we examined and
compared the results of an initial low-dose CBZ treatment in patients admitted to our
hospital.
Patients and Methods: Between July 2014 and August 2018, sixteen mCRPC
patients were enrolled and underwent a low-dose CBZ treatment at our hospital. We compared
the results with those of a Japanese metastatic docetaxel- and castration-resistant
prostate cancer Phase I study.
Results: The median patient age was 77 years (range, 53–84 years). Of the 16
patients, eight (50%) had a lymph node metastasis and 11 (68.8%) had a distant metastasis,
10 of whom had only a bone metastasis. The median dose of CBZ was 30 mg (range, 20–32 mg)
and the median number of CBZ cycles was 2.5 (range, 1–18). The PSA level of 9 (56.3%)
patients decreased after CBZ treatment, including 4 (25%) who showed a decrease to
<50%. The median time interval in which the PSA level decreased was 2 months (range,
1–18 months). The observed adverse events (AE) were neutropenia (31.3%), febrile
neutropenia (6.3%), fatigue (43.8%), nausea (18.8%), diarrhea (12.5%), decreased appetite
(25%), dysgeusia (6.3%), white blood cell count decrease (43.8%), platelet count decrease
(12.3%), and anemia (75%). However, no patient listed an AE as the reason for
discontinuing the treatment.
Conclusions: Even at a low dose, CBZ could improve the PSA value in patients
with CRPC previously treated with docetaxel. Dose reduction and prophylactic
administration of sustained G-CSF were also safe treatment options. Further studies
involving an introduction period including a modulation of duration and dose are
necessary, especially in Japanese patients.
Collapse