Cabazitaxel vs. abiraterone or enzalutamide in metastatic prostate cancer

The CARD investigators assessed the safety and efficacy of cabazitaxel in a sample population of patients with metastatic castration-resistant prostate cancer.

The CARD investigators assessed the safety and efficacy of cabazitaxel in a sample population of patients with metastatic castration-resistant prostate cancer. All of the men underwent previous docetaxel therapy coupled with either abiraterone or enzalutamide, two androgen-signaling-targeted inhibitors, but saw their disease progress within 1 year under that regimen. For the study, 129 participants were randomized to treatment with cabazitaxel while 126 were assigned to one of the alternative inhibitors. The primary outcome was imaging-based progression-free survival. At followup of a median 9.2 months, imaging-based cancer progression or death was documented in 73.6% of the cabazitaxel group and 80.2% in the comparator group. Median imaging-based progression-free survival lasted 8 months with cabazitaxel as opposed to 3.7 months with the androgen-signaling-targeted inhibitors while overall survival was a median 13.6 months and 11 months, respectively. The results indicate that cabazitaxel improves clinical outcomes, with no new safety concerns, in patients with metastatic castration-resistant prostate cancer who previously were treated with docetaxel plus abiraterone or enzalutamide.