785P - Early neutropenia is associated with survival in men with metastatic castration-resistant prostate cancer (mCRPC) when treated with cabazitaxel: An...

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Complications of Treatment
Prostate Cancer
Presenter Alexander Meisel
Citation Annals of Oncology (2014) 25 (suppl_4): iv255-iv279. 10.1093/annonc/mdu336
Authors A. Meisel1, S. von Felten2, J.S. De Bono3, R. De Wit4, O. Sartor5, F. Stenner-Liewen6
  • 1Klinik Und Poliklinik Für Onkologie, Universitätsspital Zürich, 8091 - Zurich/CH
  • 2Clinical Trial Unit, Universitätsspital Basel, 4031 - Basel/CH
  • 3Research, Royal Marsden Hospital NHS Foundation Trust, SM2 5PT - Sutton/GB
  • 4Department Of Medical Oncology, Erasmus University Medical Center, Erasmus MC Cancer Institute, NL-3075 EA - Rotterdam/NL
  • 5Department Of Medicine: Section Of Hematology & Medical Oncology And Department Of Urology, Tulane Cancer Center, 70112 - New Orleans/US
  • 6Onkologie, Universitätsspital Basel, 4031 - Basel/CH

Abstract

Aim

In TROPIC trial cabazitaxel (CBZ) plus prednisone (P) showed a significant overall survival (OS) benefit versus mitoxantrone plus P in mCRPC patients progressing during or after docetaxel. The most common adverse event in this trial was grade ≥ 3 neutropenia (82%). In this post-hoc analysis of TROPIC, we analysed the influence of chemotherapy-induced neutropenia on OS.

Methods

The lowest neutrophil count (ANC) was collected during the first cycle in 371 patients treated with CBZ. The influence of the lowest absolute neutrophil count (ANC) as a continuous variable after cycle 1 was evaluated in a Cox proportional-hazard survival model, adjusted for performance status, pain and measurable disease at baseline.

Results

A low ANC during cycle 1, good performance status and absence of pain were associated with a significantly greater OS (Table 1). Median OS was 14.3 months (95% CI 12.9, 16.7) in pts. with Grad 0-2 Neutropenia and 15.4 months (95% CI 14.3, 17.9) in pts. with Grade 3-4 neutropenia.  

Variable HR 95% CI P value
Lowest neutrophil count by Day 8* 1.13 [1.02-1.26] 0.022
ECOG perfomance status (0-1 vs 2) 2.75 [1.72-4.41] <0.001
Pain (No vs Yes) 2.07 [1.53-2.80] <0.001
Measurable disease (No vs Yes) 1.15 [0.87-153] 0.324

*continuous variable - 67 missing values

Conclusions

CBZ associated neutropenia needs to be managed carefully to avoid complications leading to treatment delay or discontinuation. Our results suggest that a low ANC during cycle 1 may be associated with an OS benefit. These data deserve confirmation in prospective studies. Source of funding: Sanofi.

Disclosure

O. Sartor: Investigator and Consultant for sanofi; F. Stenner-Liewen: The author has received honoraria from Sanofi for advisory boards. All other authors have declared no conflicts of interest.