Abstract 3524
Background
Cabazitaxel (CAB) was marketed in 2012 in Italy, based on overall survival (OS) benefit demonstrated on the TROPIC study in mCRPC post-docetaxel. The efficacy and tolerability of CAB is overlapping in all age groups, though for very elderly patients (pts) it has never really been verified.
Methods
We conducted a retrospective, observational real-life study in 57 octogenarian pts, treated with CAB in eleven Italian cancer centers from 2012 to 2018. Feasibility of treatment has been investigated by duration of treatment and its tolerability. Duration of treatment and toxicity profile were also evaluated according to ≥ 85 years, ECOG performance status (PS) ≥ 2 and comprehensive geriatric assessment (CGA) questionnaire.
Results
This retrospective cohort included 57 mCRPC pts (median age 83.5 years; 21% aged over 85 years), 24% with exclusive bone metastatic disease, 50% with high-volume bone disease, 15% with high volume bone disease and visceral disease. Thirty-nine (68%) received the CGA questionnaire assessment, 34 resulted fit and 5 vulnerable. Ten (14%) had an ECOG PS ≥ 2, 9% received CAB as second-line, 23 (40%) as third-line, 29 (51%) as forth or more line. CAB was administered at 25 mg/sqm in 30 (52%) pts, and 20 mg/sqm or adapted schedules in 27 (48%). These latter schedules were adopted mainly in the subgroups with age > 85 years (75%), PS ≥ 2 (87.5%) and vulnerable according CGA questionnaires (100%). The median duration of treatment with CAB in all pts was 4.8 months, range 1-19 months (mo); 4.5 mo in those aged > 85 years, 4.4 mo in the vulnerable pts and 3.5 mo in pts with PS ≥ 2. The most represented grade 3-4 toxicity in the whole cohort were neutropenia (14%) and diarrhea (10.5%). Six patients (10.5%) drop out the treatment for significant toxicities: 3 febrile neutropenia G4, 2 diarrhea G4 and 1 severe cardiotoxicity, 5 (83%) of these pts received the 25 mg/sqm schedule, and 4 pts (67%) aged between 80-84 yeras with ECOG PS = 0 did not performed the CGA assessment before treatment. One death due to intestinal perforation non-clearly treatment-related was reported.
Conclusions
Octogenarian patients may be treated with CAB with the 20 mg/sqm regimen associated with less treatment interruptions. The CGA could contribute to better select pts.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2600 - Atezolizumab (atezo) vs chemotherapy (chemo) in patients (pts) with platinum-treated locally advanced or metastatic urothelial carcinoma (mUC): a long-term overall survival (OS) and safety update from the Phase III IMvigor211 study
Presenter: Michiel Van der Heijden
Session: Poster Display session 3
Resources:
Abstract
3598 - Three-Year Follow-Up From the Phase 3 KEYNOTE-045 Trial: Pembrolizumab (Pembro) Versus Investigator’s Choice (Paclitaxel, Docetaxel, or Vinflunine) in Recurrent, Advanced Urothelial Cancer (UC)
Presenter: Andrea Necchi
Session: Poster Display session 3
Resources:
Abstract
2382 - First Report of Efficacy and Safety From a Phase 2 Trial of Tislelizumab, an Anti-PD-1 Antibody, for the Treatment of PD-L1+ Locally Advanced or Metastatic Urothelial Carcinoma (UC) in Asian Patients
Presenter: Dingwei Ye
Session: Poster Display session 3
Resources:
Abstract
2388 - Quality of Life of Metastatic Urothelial Cancer (mUC) Patients Treated with Enfortumab Vedotin (EV) Following Platinum-Containing Chemotherapy and a Checkpoint Inhibitor (CPI): Data from EV-201 Cohort 1
Presenter: Bradley McGregor
Session: Poster Display session 3
Resources:
Abstract
3748 - Safety and efficacy of atezolizumab (atezo) in patients (pts) with autoimmune disease (AID): subgroup analysis of the SAUL study in locally advanced/metastatic urinary tract carcinoma
Presenter: Yohann Loriot
Session: Poster Display session 3
Resources:
Abstract
1126 - Validation of the VIO prognostic index in patients with metastatic urothelial carcinoma treated with immune-checkpoint inhibitors
Presenter: Rafael Morales Barrera
Session: Poster Display session 3
Resources:
Abstract
3693 - Pathologic outcomes after neoadjuvant chemotherapy for high-risk muscle invasive bladder cancer
Presenter: Justin Matulay
Session: Poster Display session 3
Resources:
Abstract
4840 - Analysis of response to prior therapies and therapies after treatment with erdafitinib in fibroblast growth factor receptor (FGFR)-positive patients (pts) with metastatic urothelial carcinoma (mUC)
Presenter: Arlene Siefker-Radtke
Session: Poster Display session 3
Resources:
Abstract
1221 - Clinical outcomes by sex with atezolizumab (atezo) monotherapy in patients (pts) with locally advanced/metastatic urothelial carcinoma (mUC)
Presenter: Jean Hoffman-censits
Session: Poster Display session 3
Resources:
Abstract
1715 - National Small Cell Bladder Cancer Audit: Results from 26 UK institutions
Presenter: Caroline Chau
Session: Poster Display session 3
Resources:
Abstract