3524 - Cabazitaxel For Octogenarian Patients With Metastatic Castration-Resistant Prostate Cancer (MCRPC).

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

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.