Overcoming Barriers to Cabazitaxel and Optimizing Sequencing

This segment addresses practical considerations for using cabazitaxel in mCRPC, focusing on real-world treatment patterns and sequencing strategies. Patient and disease characteristics, along with prior therapies, significantly influence when cabazitaxel is most appropriately utilized.

Sequencing Challenges: A critical discussion point involves impression patterns and prior use of ARPIs/Pluvicto, particularly in patients with visceral disease. Real-world data suggests potential underutilization of cabazitaxel in mCRPC despite evidence supporting its efficacy. The conversation explores strategies to better align treatment decisions with clinical guidelines and emerging data trends.

Patient Counseling: When discussing cabazitaxel with patients, physicians should address both benefits and risks transparently. An important consideration highlighted is the FDA emphasis on overall survival (OS) versus progression-free survival (PFS). This distinction is clinically meaningful, as OS represents the most definitive endpoint for assessing treatment benefit, particularly relevant when counseling patients about realistic expectations and treatment goals.

Overcoming Barriers: Barriers to cabazitaxel use may include perceptions about toxicity, sequencing uncertainty, and competition from newer agents. However, understanding where cabazitaxel provides unique value—particularly regarding OS benefit—can help overcome these barriers.

The segment emphasizes that optimal sequencing requires integrating multiple factors: disease characteristics, prior treatment exposure, patient preferences, and comparative efficacy data. By addressing misconceptions and focusing on meaningful outcomes like OS, clinicians can make more informed decisions about incorporating cabazitaxel into individualized treatment plans for mCRPC patients.