Management of Post-orchidectomy Stage I Classical Seminoma: 11 Year Outcome Data of a Regional Cancer Unit

Abstract

Aim: The TROPIC trial [1] demonstrated improved overall survival in patients with metastatic castration-resistant prostate cancer who had progressed during or after treatment with docetaxel. The trial established cabazitaxel as a tolerable and viable second-line treatment option in these patients. We reportourexperience with cabazitaxel inpatients receiving treatment within the Early Access Programme (EAP) and via the Cancer Drugs Fund (CDF). Materials and methods: Retrospective review of patients receiving cabazitaxel chemotherapy from 1 January 2011 to1 January2012. Patients were identified using the pharmacy database. Chemotherapy administration was corroborated via the electronic prescribing system. Patient records provided documentation regarding disease response and treatment toxicities. For patients within the EAP, data were confirmed and supplemented via the Trials Office. Results: 22 patients were identified, of whom 20 received cabazitaxel. 12 patients were treated within the EAP and 8 received cabazitaxel via the CDF. Median age was 68.5 years for the EAP group and 70 years for the CDF group. Median number of cycles was 6 for the EAP and 5.5 for the CDF patients, respectively. Primary GCSF was received by 91.6% of EAP patients and by 75% of CDF patients. Overall, 3/20 patients had treatment discontinued due to progressive disease (after a minimum of 3 cycles of cabazitaxel). 13/20 patients derived a positive biochemical and/or clinical response from treatment. There were no treatment-related deaths. Notable treatment-related adverse events for all patients included: diarrhoea (40%), fatigue (25%), neutropenic sepsis (10%) and thrombocytopenia (5%). Our results are comparable with the TROPIC data [1], which reported the following results: diarrhoea (37%), fatigue (47%), neutropenic sepsis (8%), thrombocytopenia (46%) as well as peripheral neuropathy (14%) and cardiotoxicity (1%). Conclusion: Our results are comparable with the TROPIC data, suggesting cabazitaxel has an acceptable toxicity profile with demonstrable treatment response. Reference