of metastatic castration-resistant prostate cancer (mCRPC) with a combination of
cabazitaxel and carboplatin showed improved clinical efficacy compared with
cabazitaxel alone, according to the findings of a phase 2 trial.
investigators stated that, to their knowledge, the trial is the first to
establish the benefit of combining a platinum agent with a taxane agent in
mCRPC using a randomized, prospective trial design.
For the trial, Ana M. Aparicio, MD, of the University of Texas MD Anderson Cancer Center in Houston and colleagues randomly 160 men with mCRPC to receive cabazitaxel alone (79 patients) or cabazitaxel plus carboplatin (81 patients). At a median follow-up of 31 months, the combination arm had significantly longer median progression-free survival compared with the monotherapy arm (7.3 vs 4.5 months). Patients who received the dual regimen had a significant 31% decreased risk of progression compared with those in the cabazitaxel-only recipients, Dr Aparicio and her colleagues reported in Lancet Oncology.
3-4 adverse events occurred more frequently in the combination than monotherapy
arm. The most common were fatigue (occurred in 20% and 9% of the combination and
monotherapy arms, respectively), anemia (23% and 4%), neutropenia (16% and 4%),
and thrombocytopenia (14% and 1%). No treatment-related deaths occurred.
analyses suggest that the combined treatment appeared to benefit patients with
aggressive variant prostate cancer features, but not those without.
results of our study support the hypothesis that carboplatin added to cabazitaxel
improves median progression-free survival and response in men with metastatic
castration-resistant prostate cancer, and they show that the combination was
safe and tolerable with appropriate antiemetic and growth factor support,” the
PG, Heath EI, Zurita A, et al. Cabazitaxel plus carboplatin for the treatment
of men with metastatic castration-resistant prostate cancers: a randomized,
open-label, phase 1-2 trial [published online September 9, 2019]. Lancet Oncol. doi: