Parente Phillip, Ng Siobhan, Parnis Francis, Guminski Alex, Gurney Howard
Eastern Health Clinical School, Box Hill Hospital, Monash University, Melbourne, VIC, Australia.
St John of God Private Hospital, Subiaco, WA, Australia.
Asia Pac J Clin Oncol. 2017 Dec;13(6):391-399. doi: 10.1111/ajco.12679. Epub 2017 May 10.
Cabazitaxel is a next generation taxane that has been shown to improve overall survival in patients with metastatic castration-resistant prostate cancer (mCRPC) whose disease progressed during or after docetaxel-based therapy. A worldwide early access program (EAP) study was established to provide access to cabazitaxel ahead of commercial availability and to evaluate its safety and tolerability. The Australian EAP included patient-reported outcomes to evaluate the impact of cabazitaxel on quality of life (QoL). The final safety and QoL results from the Australian EAP for cabazitaxel are reported.
Australian patients with mCRPC previously treated with a docetaxel-containing regimen received cabazitaxel (25 mg/m ) every 3 weeks plus prednisone/prednisolone (10 mg daily) until disease progression, death, unacceptable toxicity, physician's decision or patient's refusal of further treatment. QoL data was collected using the AQoL-8D questionnaire.
104 patients from 18 Australian sites (median age at baseline, 70) enrolled in the EAP and completed at least one AQoL-8D questionnaire. Patients received a median of 6 cycles of cabazitaxel. 67 patients (64.4%) experienced grade ≥3 treatment-emergent adverse events (TEAEs); the most frequent TEAEs were neutropenia, febrile neutropenia, diarrhoea, and vomiting. QoL scores remained stable with increasing treatment cycles.
The results suggest that the safety profile cabazitaxel is manageable in the Australian clinical practice setting and that QoL is maintained with little or no detrimental effect of cabazitaxel in patients continuing on treatment without disease progression.
卡巴他赛是一种新一代紫杉烷类药物,已显示可改善转移性去势抵抗性前列腺癌(mCRPC)患者的总生存期,这些患者在基于多西他赛的治疗期间或之后疾病进展。一项全球早期获取计划(EAP)研究得以开展,以便在卡巴他赛商业化上市之前让患者能够使用该药,并评估其安全性和耐受性。澳大利亚的EAP纳入了患者报告的结局,以评估卡巴他赛对生活质量(QoL)的影响。本文报告了澳大利亚卡巴他赛EAP的最终安全性和QoL结果。
先前接受过含多西他赛方案治疗的澳大利亚mCRPC患者每3周接受一次卡巴他赛(25mg/m²)治疗,加用泼尼松/泼尼松龙(每日10mg),直至疾病进展、死亡、出现不可接受的毒性、医生决定或患者拒绝进一步治疗。使用AQoL-8D问卷收集QoL数据。
来自澳大利亚18个地点的104名患者(基线时的中位年龄为70岁)参加了EAP,并完成了至少一份AQoL-8D问卷。患者接受卡巴他赛的中位周期数为6个周期。67名患者(64.4%)发生了≥3级治疗中出现的不良事件(TEAE);最常见的TEAE为中性粒细胞减少、发热性中性粒细胞减少、腹泻和呕吐。随着治疗周期的增加,QoL评分保持稳定。
结果表明,在澳大利亚的临床实践环境中,卡巴他赛的安全性状况是可控的,并且对于在无疾病进展情况下继续接受治疗的患者,卡巴他赛对QoL的维持作用很小或没有不利影响。