Treatment with cabazitaxel has a 36 percent lower risk of death, according to a new study.
Prostate cancer is the third leading cause of cancer death in Europe. If the disease is “castration-resistant”, ie if it no longer responds to conventional anti-hormonal therapy, it is usually treated with chemotherapy. A change in chemotherapy treatment can pay off, according to a new study involving Viennese urologists.
The so-called CARD examination appeared in the New England Journal of Medicine on December 26th. 62 clinics in Europe were involved, in Austria the urological university clinic in Vienna (MedUni / AKH) with Gero Kramer as co-author of the scientific investigation. The study included 255 patients with prostate cancer who no longer responded to the anti-hormonal drug therapy used to suppress androgens (testosterone) and who also progressed with simultaneous treatment with the older chemotherapeutic agent docetaxel.
Patients with advanced metastatic prostate cancer were randomly assigned to two groups: half received the newer chemotherapy drug cabazitaxel or switched from one anti-hormonal drug to another (from abiraterone to enzalutamide or vice versa). Cabazitaxel is a further development from the class of taxane chemotherapeutics, which also includes the older docetaxel. Abiraterone and enzalutamide inhibit the growth signals on prostate cancer cells triggered by male sex hormones in different ways.
The results were statistically significantly consistent with the use of the newer chemotherapeutic agent: the mean period of time until the progression of the disease, as determined by imaging examination, doubled in approximately – from 3.7 months to eight months. The mean survival of the patients increased from eleven months with anti-hormonal therapy to 13.6 months with chemotherapy. The tumor-relevant PSA value decreased under the changed anti-hormonal therapy in 13.5 percent of those treated, but in 35.7 percent among the patients who had received cabazitaxel. The side effect rates were approximately the same. The mean observation period (half below, half above) was 9.2 months.
“Cabazitaxel treatment brought about a 36 percent lower risk of death from all causes compared to treatment with abiraterone or enzalutamide,” the authors of the scientific study wrote. This was even ascertainable, although a third of the patients on anti-hormonal therapy also switched to the chemotherapy group during the study due to the progression of the disease.