766TiP - CARD: A randomized phase 4 trial comparing cabazitaxel and an androgen receptor (AR)-targeted agent in men with metastatic castration-resistant pro...

Date 09 October 2016
Event ESMO 2016 Congress
Session Poster display
Topics Anti-Cancer Agents & Biologic Therapy
Prostate Cancer
Presenter Ronald de Wit
Citation Annals of Oncology (2016) 27 (6): 243-265. 10.1093/annonc/mdw372
Authors R. de Wit1, K. Fizazi2, E. Efstathiou3, R. Dittamore4, S. Hitier5, K. Pantel6, C. Sternberg7, B.F. Tombal8, C. Wülfing9, J. de Bono10
  • 1Medical Oncology, Erasmus University Medical Center, 3075EA - Rotterdam/NL
  • 2Department Of Cancer Medicine, Institut Gustave Roussy, 94805 - Villejuif/FR
  • 3Gu Medical Oncology  , md anderson cancer center  , 77030   - Houston/US
  • 4Translational Research, Epic Sciences Inc., 92121 - San Diego/US
  • 575, Sanofi, 75008 Paris - Paris/FR
  • 6Tumor Biology, UKE Universitätsklinikum Hamburg-Eppendorf KMTZ, 20246 - Hamburg/DE
  • 7Oncology, San Camillo–Forlanini Hospital, 00152 - Rome/IT
  • 8Urology, Cliniques Universitaires St. Luc, 12000 - Brussels/BE
  • 9Urology, Asklepios Klinik Altona, 22763 - Hamburg/DE
  • 10Oncology, Royal Marsden Hospital NHS Foundation Trust, SW3 6JJ - London/GB



mCRPC is highly heterogeneous with coexistence of AR-dependent and AR-independent tumor clones. New AR-targeted agents (abiraterone acetate, enzalutamide) and taxanes (docetaxel (DOC), cabazitaxel - specifically developed to overcome DOC resistance) are the backbone of mCRPC therapy. The rising concern of cross-resistance between mCRPC therapies and the evidence that some patients may not respond to all available drugs have increased the complexity of managing mCRPC. There is thus a need to design trials helping to define the optimal sequence of therapies to optimize patient outcomes.

Trial design

CARD is a randomized phase 4 trial involving 79 sites in 12 European countries. A total of 324 patients with mCRPC previously treated with DOC and who failed a prior AR-targeted agent (abiraterone acetate or enzalutamide, either before or after DOC) within 12 months of AR-targeted treatment initiation will be randomized (1:1) to receive cabazitaxel (25mg/m2 every 3 weeks plus daily prednisone and prophylactic G-CSF) or the alternative AR-targeted agent until radiographic progression, unacceptable toxicity or patient's request. Randomization will be stratified by ECOG performance status (0-1 vs. 2), time to progression with prior AR-targeted agent (

Clinical trial identification


Legal entity responsible for the study





R. de Wit: Research grant from Sanofi International coordinator of CARD study Consulting fees from Sanofi.

R. de Wit: Research grant from Sanofi. Consulting fee from Sanofi CARD investigator and Steering committee member.

K. Fizazi: Paid advisor at Sanofi advisory boards Investigator and steering committee member for CARD study.

E. Efstathiou: Research grant from Sanofi. Paid advisor at Sanof advisory boards. Investigator and steering Committee member of CARD study.

R. Dittamore: Employee of Epic Sciences, Inc., La Jolla, USA.

S. Hitier: CARD statistician - Employee of Sanofi.

K. Pantel: Member of CARD translational steering committee.

C. Sternberg: Investigator and steering committee member of CARD study. Consulting fee from Sanofi

B. Tombal: Paid advisor by Sanofi Investigator and Steering Committee member of CARD study.

C. Wülfing: Investigator and steering committee member of CARD study.

J. de Bono: Johann de Bono served on Sanofi advisory boards as a paid advisor. He is also investigator and member of CARD Steering committee.