medwireNews: The patient-reported outcomes (PROs) from the CARD trial of third-line cabazitaxel in men with metastatic castration-resistant prostate cancer (mCRPC) add support for using the taxane in this setting, say researchers.
Presenting the data on behalf of his fellow investigators, Karim Fizazi, from Institut Gustave Roussy in Villejuif, France, highlighted that pain outcomes were significantly better with cabazitaxel than with abiraterone or enzalutamide, while changes in health-related quality of life (HRQoL) were numerically better.
These results, together with the previously reported efficacy data favoring cabazitaxel, suggest that the taxane should be the standard third-line option in these patients instead of abiraterone or enzalutamide, he told the audience at the 2020 Genitourinary Cancers Symposium in San Francisco, California, USA.
The phase 4 trial comprised 255 men who had received docetaxel for mCRPC and experienced progression within a year of treatment with the androgen signaling-targeted inhibitors abiraterone or enzalutamide. Participants were randomly assigned to receive cabazitaxel 25 mg/m2 every 3 weeks or either abiraterone or enzalutamide, depending on which of the two they had received prior to study entry.
ASCO expert Robert Dreicer discusses the CARD trial, aas well as other important prostate cancer trials presented at ASCO GU 2020 (3:07).
A significantly higher proportion of patients in the cabazitaxel than abiraterone or enzalutamide arm had a pain response, at 45.0% versus 19.3%, where response was defined as a 30% or greater decrease in Brief Pain Inventory-Short Form (BPI-SF) pain intensity scores from baseline at two evaluations at least 3 weeks apart without an increase in analgesic use.
And cabazitaxel-treated patients were significantly less likely to experience pain progression (≥30% increase in BPI-SF scores from baseline) than their counterparts given abiraterone or enzalutamide at all timepoints up to 12 months, at which point a respective 66.2% and 45.3% of participants were free from pain progression.
HRQoL assessments, using the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire, also tended to favor cabazitaxel treatment, which was associated with a greater, albeit not statistically significant, likelihood of no deterioration across most of the FACT-P domains.
Similarly, the median time to deterioration in FACT-P scores was longer with cabazitaxel than with abiraterone or enzalutamide, at 14.8 versus 8.9 months (hazard ratio=0.72), but the between-group difference did not reach statistical significance.
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2020 Genitourinary Cancers Symposium; San Francisco, California, USA: 13–15 February