Background: The recommended starting dose of cabazitaxel for castration-resistant prostate cancer (CRPC) is 25 mg/m in Japan and Europe. Although lower doses are established alternatives based on randomized controlled trials, the safety and efficacy of 25 and 20 mg/m in real-world settings are not well established. Therefore, we investigated the safety and efficacy of cabazitaxel at the recommended starting dose or a lower dose (20 mg/m) in real-world clinical practice.
Methods: We compared the safety and efficacy of cabazitaxel between patients who received cabazitaxel at starting doses of 25 and 20 mg/m (C25 and C20, respectively) in a Japanese post-marketing surveillance study of 662 patients with docetaxel-refractory CRPC. Safety was assessed in terms of adverse drug reactions (ADRs). Prostate-specific antigen (PSA) response rate, overall survival (OS), and time-to-treatment failure (TTF) were compared between the C25 and C20 groups in unmatched patients and after applying propensity score matching.
Results: The C20 and C25 groups comprised 190 and 159 patients without matching and 112 patients per group after matching. In unmatched patients, any-grade (C25 vs C20: 89.3% vs 78.4%, Fisher's p < 0.01) and grade ≥ 3 (81.1% vs 61.1%) ADRs were more frequent in the C25 group. Neutropenia (any grade: 61.6% vs 54.2%; grade ≥ 3: 55.3% vs 42.6%) and febrile neutropenia (grade ≥ 3: 30.2% vs 14.7%) were more frequent in the C25 group. In matched patients, the PSA response rate (reduction in PSA ≥30% from a baseline ≥5 ng/mL) was 26.4 and 32.0% in the C20 and C25 groups, respectively, median OS was 291 days (95% CI 230-not reached) versus not reached (hazard ratio 0.73, 95% CI 0.50-1.08), and TTF favored C25 (hazard ratio 0.75, 95% CI 0.57-0.99).
Conclusions: Clinicians should consider the patient's risk of clinically significant ADRs and prophylactic granulocyte colony stimulating factor when selecting the starting dose of cabazitaxel for CRPC. Some patients at high risk of ADRs or unfit patients may benefit from a lower starting dose of 20 mg/m, whereas fit patients may be candidates for a starting dose of 25 mg/m.
Trial Registration: Not applicable.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359263 | PMC |
http://dx.doi.org/10.1186/s12885-020-07131-6 | DOI Listing |
Diabetol Metab Syndr
January 2025
Serviço de Endocrinologia (SEMPR) do Hospital das Clínicas da Universidade Federal do Paraná (UFPR), Curitiba, Brazil.
Background: Type 2 diabetes mellitus (T2D) is a global health concern with a rising prevalence, particularly in Brazil. Insulin therapy plays a crucial role in managing T2D, helping to maintain glucose and energy homeostasis. Moreover, early initiation of insulin is crucial for hyperglycemic control and prevention of chronic complications.
View Article and Find Full Text PDFSyst Rev
January 2025
Department of Neurosurgery, Pingxiang People's Hospital, Pingxiang, Jiangxi Province, 337000, China.
Background: A systematic appraisal of the comparative efficacy and safety profiles of naso-intestinal tube versus gastric tube feeding in the context of enteral nutrition for mechanically ventilated (MV) patients is imperative. Such an evaluation is essential to inform clinical practice, ensuring that the chosen method of nutritional support is both optimal and safe for this patient population.
Methods: We executed an exhaustive search across PubMed et al.
BMC Cancer
January 2025
The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou, 730030, China.
Background: Chemotherapy-induced nausea and/or vomiting (CINV) is an intractable adverse effect of anticancer drugs. Although prophylactic use of fosaprepitant may be effective in reducing CINV, there is a lack of studies evaluating the application of fosaprepitant in real world.
Aims And Methods: This study prospectively observed the effectiveness and safety for the prophylaxis of CINV in a real-world clinical setting.
Lasers Med Sci
January 2025
Shree Guru Gobind Singh Tricentenary University, Budhera-Gurugram, Haryana, 122006, India.
Numerous research studies have delved into the potential effect of LASER therapy on alleviating pain associated with plantar fasciitis. However, the distinct effects of both High Intensity and Low Intensity LASER therapy (HILT/LILT) on addressing plantar fasciitis pain have not been thoroughly investigated. This systematic review seeks to provide a comprehensive summary of the present body of literature regarding the use of LASER therapy in managing pain related to plantar fasciitis.
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Department of Neurosurgery, Hospital Heliópolis, São Paulo, Brazil.
Basal ganglia hemorrhage (BGH) is a prevalent site for intracerebral hemorrhage. Although neuroendoscopy (NE) surgery has emerged as a less invasive alternative to craniotomy (CT), the optimal surgical method remains debatable. This systematic review and meta-analysis aimed to compare the efficacy and safety of NE versus CT in the management of BGH.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!