Dr. de Wit on the AEs With Cabazitaxel in the CARD Trial in mCRPC

Ronald de Wit, MD, PhD, group leader, Experimental Systematic Therapy of Urogenital Cancers program, Erasmus MC Cancer Institute, Rotterdam, Netherlands, discusses the adverse events (AEs) with cabazitaxel (Jevtana) in the phase III CARD trial in patients with metastatic castration-resistant prostate cancer (mCRPC).

In the phase III CARD trial, cabazitaxel showed a significant improvement in overall survival and radiographic progression-free survival versus enzalutamide (Xtandi) or abiraterone acetate (Zytiga) in the third-line treatment of patients with mCRPC.

Additionally, the rate of AEs was comparable between arms despite the fact that the median duration of treatment was longer in patients receiving cabazitaxel versus those receiving an androgen receptor (AR) inhibitor. The rate of serious AEs in the cabazitaxel and AR inhibitor arms was 38.9% and 38.7%, respectively. Neutropenic fever was a concern with cabazitaxel, says de Wit; however, the use of primary prophylactic granulocyte-colony stimulating factor was required in each cycle of cabazitaxel therapy.

Regarding grade ≥3 AEs, patients in the cabazitaxel arm were more likely to experience severe asthenia/fatigue (4.0 vs 2.4%), diarrhea (3.2 vs 0%), peripheral neuropathy (3.2 vs 0%), and febrile neutropenia (3.2 vs 0%) compared with those in the AR inhibitor arm. However, patients in the cabazitaxel arm were less likely to experience grade ≥3 renal disorders (3.2 vs 8.1%), musculoskeletal pain (1.6 vs 5.6%), cardiac disorders (0.8 vs 4.8%) and spinal cord or nerve root disorders (2.4 vs 4.0%) compared with those in the AR inhibitor arm.