Pain Progression at Initiation of Cabazitaxel in Metastatic Castration-Resistant Prostate Cancer (mCRPC): A Post Hoc Analysis of the PROSELICA Study

Cancers

Ronald de Wit¹  Debbie Robbrecht¹  Mario Eisenberger²  Stéphane Oudard³  Nicolas Delanoy³  Oliver Sartor⁴  Christine Geffriaud-Ricouard⁵  Florence Mercier⁶  Johann de Bono⁷ 

[1] Medical Oncology, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands;Medical Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD 21231, USA;Medical Oncology, Université de Paris, 75015 Paris, France;Medicine and Urology, Tulane Cancer Center, New Orleans, LA 70112, USA;Sanofi, Europe Medical Oncology, 75008 Paris, France;Stat Process, Boulevard de Sébastopol, 75003 Paris, France;The Institute of Cancer Research, London SM2 5NG, UK;

关键词: cabazitaxel;    chemotherapy;    clinical progression;    metastatic castration-resistant prostate cancer;    pain;    taxanes;   

DOI  :  10.3390/cancers13061284

来源: DOAJ

【 摘 要 】

Background: In the PROSELICA phase III trial (NCT01308580), cabazitaxel 20 mg/m² (CABA20) was non-inferior to cabazitaxel 25 mg/m² (CABA25) in mCRPC patients previously treated with docetaxel (DOC). The present post hoc analysis evaluates how the type of progression at randomization affected outcomes. Methods: Progression type at randomization was defined as follows: PSA progression only (PSA-p; no radiological progression (RADIO-p), no pain), RADIO-p (±PSA-p, no pain), or pain progression (PAIN-p, ±PSA-p, ±RADIO-p). Relationships between progression type and overall survival (OS), radiological progression-free survival (rPFS), and PSA response (confirmed PSA decrease ≥ 50%) were analyzed. Results: All randomized patients (n = 1200) had received prior DOC, and 25.7% had received prior abiraterone or enzalutamide. Progression type at randomization was evaluable in 1075 patients (PSA-p = 24.4%, RADIO-p = 20.8%, PAIN-p = 54.8%). Pain progression was associated with clinical and biological features of aggressive disease. Median OS from CABA initiation or date of mCRPC diagnosis, all arms combined, was shorter in the PAIN-p group than in the RADIO-p or the PSA-p groups (12.0 versus 16.8 and 18.4 months, respectively, p < 0.001). In multivariate analysis, all arms combined, PAIN-p was an independent predictor of poor OS (HR = 1.44, p < 0.001). PSA response, rPFS, and OS were numerically higher with CABA25 versus CABA20 in patients with PAIN-p. Conclusions: This post hoc analysis of the PROSELICA phase III study shows that pain progression at initiation of CABA in mCRPC patients previously treated with DOC is associated with a poor prognosis. Disease progression should be carefully monitored, even in the absence of PSA rise.

【 授权许可】

Unknown