Azuma Keiichi, Kawakami Kazuyoshi, Yuasa Takeshi, Sugisaki Takahito, Hashimoto Koki, Aoyama Takeshi, Suzuki Kenichi, Yonese Junji, Hama Toshihiro
Dept. of Pharmacy, Cancer Institute Hospital, Japanese Foundation for Cancer Research.
Gan To Kagaku Ryoho. 2018 Dec;45(12):1737-1742.
Cabazitaxel, which is a novel semi-synthetic anti-cancerous agent, is newly approved for the treatment of metastatic castration resistant prostate cancer(CRPC). The main dose-limiting toxicity is considered to be febrile neutropenia(FN). In this study, we retrospectively investigated the safety profiles of Japanese patients during cabazitaxel therapy. From September 2014 to August 2016, 17 patients initiated receiving cabazitaxel therapy in our institution. Prophylactically, pegfilgrastim was administered to all patients. Among 17 patients, 5 patients(29.4%)developed FN. Four of these patients(80%)developed FN in the first cycle and could continue the cabazitaxel therapy with dose modification, whereas 1 patient(20%)developed FN leading to septic shock in the 8th cycle. Although he recovered after appropriate medical treatment, he discontinued the cabazitaxel therapy. Regarding non-hematological adverse events, no unknown adverse events were observed. The most frequently observed adverse event was back pain(n=4, 23.5%). There was no influence on the continuation of treatment. Treatment discontinuation due to adverse events was observed in 1 patient(5.9%). Due to the prophylactic pegfilgrastim in combination, the occurrence rate of FN seemed to decrease. However, we must remember that FN is still frequently expressed even under the prophylactic pegfilgrastim.
卡巴他赛是一种新型半合成抗癌药物,最近被批准用于治疗转移性去势抵抗性前列腺癌(CRPC)。主要的剂量限制性毒性被认为是发热性中性粒细胞减少症(FN)。在本研究中,我们回顾性调查了日本患者接受卡巴他赛治疗期间的安全性。2014年9月至2016年8月,17例患者在我们机构开始接受卡巴他赛治疗。预防性地,所有患者均接受了培非格司亭治疗。17例患者中,5例(29.4%)发生了FN。其中4例患者(80%)在第一个周期发生FN,可通过调整剂量继续卡巴他赛治疗,而1例患者(20%)在第8个周期发生FN并导致感染性休克。尽管经过适当治疗后康复,但他停止了卡巴他赛治疗。关于非血液学不良事件,未观察到未知的不良事件。最常观察到的不良事件是背痛(n = 4,23.5%)。对治疗的持续进行没有影响。1例患者(5.9%)因不良事件而停止治疗。由于联合使用预防性培非格司亭,FN的发生率似乎有所降低。然而,我们必须记住,即使在预防性使用培非格司亭的情况下,FN仍经常出现。