Cabazitaxel does not reduce quality of life (QoL) for patients with metastatic castration-resistant prostate cancer compared with a second androgen signaling-targeted inhibitor, according to an analysis of the phase 4 CARD study (Lancet Oncol. 2020. doi:10.1016/S1470-2045[20]30449-6).
“In the CARD study, cabazitaxel significantly improved radiographic progression-free survival and overall survival versus abiraterone or enzalutamide in patients with metastatic castration-resistant prostate cancer previously treated with docetaxel and the alternative androgen signalling-targeted inhibitor,” wrote Prof Karim Fizazi, MD, Institut Gustave Roussy and University of Paris, France, and colleagues.
This analysis reports on QoL outcomes from the CARD study.
During just over a 3-year period, 303 study subjects were randomly assigned to receive cabazitaxel (n = 129) or either abiraterone or enzalutamide (n = 126). Researchers followed the patients for between 5.6 and 13.2 months (median 9.2 months).
In addition to the previously reported primary end point of radiographic progression-free survival, subjects underwent analysis of pain response, time to pain progression, time to symptomatic skeletal events and patient-reported outcomes using the Functional Assessment of Cancer Therapy–Prostate (FACT-P) questionnaire and the EuroQoL–5 dimensions, 5 level scale (EQ-5D-5L).
Researchers noted pain response in 46% of patients in the cabazitaxel study arm and 19% of those in the opposite study arm. They were not able to estimate median time to pain progression, nor median time to symptomatic skeletal events for the patients receiving cabazitaxel. Patients in the other cohort exhibited a median 8.5 months to pain progression and a median 16.7 months to symptomatic skeletal progression.
“There was a significant treatment effects seen in changes from baseline in EQ-5D-5L utility index score in favor of cabazitaxel… but no difference between treatment groups for change in baseline EQ-5D-5L visual analog scale,” Dr Fizazi and colleagues concluded.—Jennifer Spector
