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PROSELICA: Health-related quality of life (HRQL) and post-hoc analyses for the phase 3 study assessing cabazitaxel 20 (C20) vs 25 (C25) mg/m2 post-docetaxel (D) in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC)

Date

09 Oct 2016

Session

Genitourinary tumours, prostate

Presenters

Johann de Bono

Citation

Annals of Oncology (2016) 27 (6): 243-265. 10.1093/annonc/mdw372

Authors

J.S. de Bono1, A. Hardy-Bessard2, C.S. Kim3, L. Géczi4, D. Ford5, L. Mourey6, J. Carles7, P. Parente8, A. Font9, G. Kacsó10, M. Chadjaa11, W. Zhang12, J. Bernard13, M. Eisenberger14

Author affiliations

  • 1 Division Of Clinical Studies, Drug Development Unit, Royal Marsden NHS Foundation Trust/The Institute of Cancer Research, SM2 5PT - Sutton/GB
  • 2 Centre Armoricain D'oncologie, CARIO, Plérin/FR
  • 3 Urology, Prostate Center, Urologic Cancer Center, Asan Medical Center, Seoul/KR
  • 4 Medical Oncology And Clinical Pharmacology, National Institute of Oncology, Budapest/HU
  • 5 City Hospital, Cancer Center Queen Elizabeth Hospital, Birmingham/GB
  • 6 Institut Claudius Regaud, IUCT-O, Toulouse/FR
  • 7 Vall D’hebron University Hospital, Vall d’Hebron Institute of Oncology, Barcelona/ES
  • 8 Eastern Health Clinical School, Monash University, Box Hill Hospital, Melbourne/AU
  • 9 Institut Català D’oncologia, Hospital Universitari Germans Trias i Pujol, Badalona/ES
  • 10 Medical Oncology, Amethyst Radiotherapy Center-Cluj, Cluj Napoca/RO
  • 11 Research And Development, Sanofi, Vitry-sur-Seine/FR
  • 12 Research And Development, Sanofi Genzyme, Bridgewater/US
  • 13 Research And Development, Sanofi Genzyme, Cambridge/US
  • 14 The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore/US
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Resources

Abstract 2907

Background

PROSELICA (NCT01308580) was a post-marketing requirement to demonstrate non-inferiority of C20 vs C25 in terms of overall survival (OS) in mCRPC pts who progressed on D.

Methods

Post-D mCRPC pts were randomized 1:1 to receive C25 or C20 (+ prednisone). To show non-inferiority of C20 (preservation of ≥ 50% of the incremental C25 efficacy over mitoxantrone in the TROPIC trial) with 95% confidence interval (CI), hazard ratio (HR) could not exceed 1.214 under a 1-sided 98.89% CI after interim analyses. Secondary endpoints: progression-free survival (PFS), prostate-specific antigen (PSA) and tumor response (TR), safety, HRQL (Functional Assessment of Cancer Therapy-Prostate [FACT-P] questionnaire) and pain response (PR; Present Pain Intensity score on McGill-Melzack scale). Post-hoc analyses assessed association of Grade 3–4 neutropenia on treatment and baseline (BL) neutrophil-lymphocyte ratio (NLR) with OS.

Results

1200 pts were randomized (598 C20; 602 C25). BL pt characteristics were similar for C20 and C25. See Table for efficacy results. Rates of Grade 3–4 treatment-emergent adverse events were 39.7% C20, 54.5% C25. Change in FACT-P total score from BL was not significantly different for C20 and C25. Grade 3–4 neutropenia on treatment and BL NLR 

Conclusions

In post-D mCRPC pts, C20 is non-inferior in terms of OS vs C25, meeting the study endpoint. Efficacy parameters favoured C25. Grade 3–4 neutropenia and low NLR may have prognostic value. Funding: Sanofi Genzyme.

Clinical trial identification

NCT01308580

Legal entity responsible for the study

Sanofi Genzyme

Funding

Sanofi Genzyme

Disclosure

J.S. de Bono: Received honoraria from and provided a consulting/advisory role for Sanofi Genzyme. D. Ford: Received honoraria from and provided a consulting/advisory role for Janssen and Astellas, and received reimbursement for expenses from Astellas.

J. Carles: Provided a consulting/advisory role for Johson&Johnson, Astellas, Bayer, Amgen, Pfizer, and BMS, and has participated in a speakers bureau for Bayer.

G. Kacsó: Was employed by and provided a leadership role for RTC Amethyst, has received honoraria from Sanofi Genzyme, Astra-Zeneca, Janssen, Astellas, has provided a consulting/advisory role for Janssen and Astellas, has received funding from Janssen and CNCSIS.

M. Chadjaa: Is an employee of Sanofi Genzyme.

W. Zhang: Is an employee of Sanofi Genzyme and owns stock in Sanofi Genzyme.

J. Bernard: Is an employee of Sanofi Genzyme.

M. Eisenberger: Provided a consulting/advisory role for and received reimbursement for expenses from Astellas, Bayer and Sanofi Genzyme, has received honoraria from Sanofi Genzyme and research funding from Sanofi Genzyme, Tokai Pharmaceuticals and Genentech.

All other authors have declared no conflicts of interest.

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