Real life treatment sequences and survival of men with metastatic castrate-resistant prostate cancer (mCRPC) receiving cabazitaxel in clinical practice across England.

Abstract

e573 Background: New life-prolonging anticancer treatments (LPT), including docetaxel (D), cabazitaxel (C), abiraterone (A) and enzalutamide (E) have transformed outcomes for patients with mCRPC; however, optimal treatment sequencing is unclear. The aim of this study was to describe the anticancer treatment sequencing and outcomes of patients receiving cabazitaxel in England. Methods: A multi-centre, observational, retrospective study of mCRPC patients treated with cabazitaxel after docetaxel treatment failure was conducted. Data on patient characteristics, anticancer treatments, toxicity and outcomes were collected from medical records between March 2015 and March 2016. Results: 115 patients with mCRPC from 5 English hospitals were evaluated. Mean age at cabazitaxel initiation was 69.4 (SD: 6.7) years. Median time from mCRPC diagnosis to cabazitaxel initiation was 18.0 (interquartile range: 11.4–28.7) months. Cabazitaxel was 2nd line therapy after docetaxel in 58/115 (50%) patients. Patients received a median of 3 (range: 2–4) different LPTs: 5 patients received 2 therapies (DC = 5); 89 patients received 3 therapies (DAC = 44, DCA = 32, DCE = 7, ADC = 4, DEC = 1, EDC = 1); 21 patients received 4 therapies (DACE = 9; DCAE = 5; DCEA = 5; DAEC = 2). Median overall survival (OS) from mCRPC diagnosis and from docetaxel initiation according to number of LPTs is presented in the table. Conclusions: A variety of mCRPC treatment sequences are used in real-world practice. OS was greater in those patients receiving ≥3 LPTs, with a non-significant yet intriguing trend to longer OS with DCA. Further follow up may indicate whether this will become statistically significant. [Table: see text]