Cabazitaxel and docetaxel first-line head to head

Cabazitaxel is no better than docetaxel in chemotherapy-naive metastatic castration-resistant prostate cancer (mCRPC), according to a recent trial published in the Journal of Clinical Oncology.

The FIRSTANA study assessed whether cabazitaxel 20mg/m2 or 25mg/m2 was superior to docetaxel 75 mg/m2 in terms of overall survival and tolerability in 1168 patients.

Median overall survival was 24.5 months with cabazitaxel 20mg/m2, 25.2 months with cabazitaxel 25mg/m2, and 24.3 months with docetaxel 75 mg/m2. Hazard ratio for cabazitaxel 25mg/m2 versus docetaxel 75 mg/m2 was 0.97 (95% CI, 0.82–1.16; p=0.757). Median progression free survival was 4.4 months with low dose cabazitaxel, 5.1 months with the higher dose and 5.3 months with docetaxel, with no significant differences between treatment arms. Rates of grade 3 or 4 treatment-emergent adverse events were highest with the higher dose of cabazitaxel. Febrile neutropenia, diarrhoea, and haematuria were more frequent with the higher dose of cabazitaxel; whilst peripheral neuropathy, peripheral oedema, alopecia and nail disorders were more frequent with docetaxel.

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