Oncologic response and hospitalization rate of patients receiving cabazitaxel in the fourth-line and beyond in castration-resistant prostate cancer: analysis of a retrospective cohort and a structured literature review

Background: Limited data are available for the use of agents in metastatic castration-resistant prostate cancer (mCRPC) beyond the third-line. We provide data during treatment with cabazitaxel (CAB), helping to improve the informed-consent process. Patients and Methods: We retrospectively reviewed p...

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Main Authors: Hardenberg, Jost von (Author) , Schwartz, Maike (Author) , Worst, Thomas (Author) , Nuhn, Philipp (Author) , Heinrich, Elmar (Author)
Format: Article (Journal)
Language:English
Published: December 2017
In: Urologia internationalis
Year: 2017, Volume: 99, Issue: 4, Pages: 414-421
ISSN:1423-0399
DOI:10.1159/000477943
Online Access:Verlag, Volltext: http://dx.doi.org/10.1159/000477943
Verlag, Volltext: https://www.karger.com/Article/FullText/477943
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Author Notes:Jost von Hardenberg, Maike Schwartz, Thorsten Werner, Stefan Fuxius, Arne Strauss, Thomas Stefan Worst, Philipp Nuhn, Christian Bolenz, Elmar Heinrich

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245 1 0 |a Oncologic response and hospitalization rate of patients receiving cabazitaxel in the fourth-line and beyond in castration-resistant prostate cancer  |b analysis of a retrospective cohort and a structured literature review  |c Jost von Hardenberg, Maike Schwartz, Thorsten Werner, Stefan Fuxius, Arne Strauss, Thomas Stefan Worst, Philipp Nuhn, Christian Bolenz, Elmar Heinrich 
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520 |a Background: Limited data are available for the use of agents in metastatic castration-resistant prostate cancer (mCRPC) beyond the third-line. We provide data during treatment with cabazitaxel (CAB), helping to improve the informed-consent process. Patients and Methods: We retrospectively reviewed patients treated with fourth-line or beyond CAB for mCRPC after failure of previous therapies with docetaxel, abiraterone acetate, enzalutamide and/or radium-223. The progression-free survival (PFS) and the overall survival (OS) were estimated using the Kaplan-Meier method and compared to published data based on a structured literature review. The hospitalization rate was recorded. Factors influencing 6-months OS were analyzed. Results: Fifteen patients were identified at 4 institutions and included in the analysis. The median PFS was 104 days (range 47-397 days). The median time to death was 10 months (range 2-16). PFS and OS data are in accordance with 17 published patients so far. During the therapy, eleven (73%) of the patients were hospitalized. Prostate-specific antigen (PSA, 500 units; hazards ratio [HR] 1.491, 95% CI 1.000-2.0175), white blood cell count (HR 0.425, 95% CI 0.108-0.952), hemoglobin (HR 0.6014, 95% CI 0.2942-1.0758), and alkaline phosphatase (100 units; HR 1.0964, 95% CI 1.000-1.2859) correlate with 6-months OS. Conclusions: CAB beyond the third-line is often accompanied by hospitalization. PFS is a significant proportion of the median time of OS. The baseline laboratory might be a good indicator for the decision between CAB and best-supportive care. 
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