The purpose of this study was to evaluate the efficacy of
cabazitaxel for patients with metastatic
castration-resistant
prostate cancer (mCRPC) after sequential
therapy with
docetaxel (DTX) and single or dual regimens of novel
androgen receptor-axis-targeted (ARAT) agents. We retrospectively reviewed 84 consecutive patients treated with
cabazitaxel at Kobe University Hospital and related hospitals from September 2014 to September 2016. The association of each prognostic parameter with progression-free survival (PFS) was evaluated, including the sequence of
therapy. Patients were divided according to their treatment after receiving
cabazitaxel as follows: group 1 (after DTX and single regimen of novel ARAT agent) and group 2 (after DTX and dual novel ARAT agents). Median PFS for
cabazitaxel treatment was 10.3 months (range 4.5-14.2 months).
Prostate-specific antigen (PSA) response rates (≥30%) were 46.8 and 46.1% in group 1 and group 2, respectively [p = 0.96, hazard ratio (HR) 1.02, 95% confidence interval (CI) 0.57-1.80]. PSA response rates (≥50%) were 43.8 and 26.9% in patients of group 1 and group 2, respectively (p = 0.18, HR 1.54, 95% CI 0.78-3.04). Univariate analysis revealed that PFS for
cabazitaxel treatment was significantly associated with baseline
alkaline phosphatase, bone
metastasis, and prior sequential
therapy. Multivariate analysis revealed that bone
metastasis and prior sequential
therapy were independently associated with PFS. Prior sequential
therapy with single regimen or dual regimens of novel ARAT agents was independently associated with PFS of patients with mCRPC treated with
cabazitaxel. The effect of
cabazitaxel after the administration of DTX and single novel ARAT agent was more sustained.