Managing side effects of the novel taxane cabazitaxel in castrate-resistant
prostate cancer.
Author(s): Doyle-Lindrud S.
Affiliation(s): School of Nursing, Columbia University, New York, NY, USA. smd9@columbia.edu
Publication date & source: 2012, Clin J Oncol Nurs. , 16(3):286-91
Cabazitaxel, a novel taxane, was approved in June 2010 by the U.S. Food and Drug
Administration for treatment of metastatic castrate-resistant prostate cancer
(mCRPC) in men previously treated with docetaxel. In TROPIC (N = 755), an
open-label, randomized, phase III trial, cabazitaxel (plus prednisone) was
associated with improvement in median overall survival compared with mitoxantrone
plus prednisone (15.1 versus 12.7 months, p < 0.0001) in patients with mCRPC who
had progressed following docetaxel-based regimens. That corresponds to a 30%
relative reduction in risk of death compared with the mitoxantrone regimen. In
addition, significant benefit existed in median progression-free survival with
cabazitaxel versus the mitoxantrone regimen (2.8 versus 1.4 months, p < 0.0001).
Most common adverse events (AEs) associated with cabazitaxel were hematologic;
the rates (all grade) of neutropenia, leukopenia, and anemia were greater than
90%. Diarrhea, fatigue, asthenia, and back pain were the most common grade 3 or
higher nonhematologic AEs. Because expected AEs from cabazitaxel therapy can
delay or even interrupt treatment, oncology nurses need to be aware of those
risks and their management. This article reviews the vital role of nurses in
identifying patients at high risk for AEs associated with cabazitaxel therapy and
reviews strategies for prevention and management of symptoms.
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