587P - Clinical and cost impact of cabazitaxel versus (vs) a second androgen receptor targeted agent (ARTA) for patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) previously treated with docetaxel and the alternative ARTA (abiraterone or enzalutamide)

Background

Cabazitaxel has significantly improved clinical outcomes compared to a 2^nd ARTA in mCRPC pts who previously received docetaxel and the alternative ARTA. We sought to determine resource costs avoided with cabazitaxel in 3L treatment vs a second ARTA in mCRPC pts.

Methods

Inputs were derived from CARD data, medical literature, and estimates (by 3 GU oncologists, AM,TH,NJV) of typical clinical care patterns (TCCP). An Excel model was created to assess data at 6, 12, 18, and 24 months for pts similar to CARD pts. Outcomes included number of pts without (w/o) progression and still alive, hospitalization and ICU days, and costs of management of symptomatic skeletal events (SSEs), adverse events (AEs), and end-of-life care. The cost impact was modeled for a cohort of mCRPC pts receiving cabazitaxel vs a same-size cohort receiving ARTA in 3L, costs in 2020 US$.

Results

Cabazitaxel use in 100 pts was estimated to result in 9 more pts w/o progression and 17 less deaths vs the use of a 2nd ARTA over an 18-month period (Table). The costs of SSEs, AEs, and end-of-life care were $498,909, $276,198, and $808,785, respectively, for cabazitaxel pts, and $627,569, $251,124, and $1,028,294, respectively, for ARTA pts. Cabazitaxel was associated with 58 fewer hospitalization days and 2 fewer ICU days and was estimated to avoid $323,095 in costs, driven by SSEs and end-of-life care.

Conclusions

The use of cabazitaxel as a 3L treatment after docetaxel and ARTA in mCRPC pts is predicted to result in clinical benefits (longer rPFS, OS) and fewer hospitalization and ICU days. Compared to a 2^nd ARTA, cabazitaxel was estimated to be associated with a 21% reduction in both SSE and end-of-life care costs and a 10% increase in AE costs, for an overall decrease of 17% in costs. Table: 587P

Outcomes at 18 months

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Sanofi-Genzyme.

Funding

Sanofi-Genzyme.

Disclosure

A.K. Morgans: Financial Interests, Institutional, Advisory Board: Astellas; Financial Interests, Institutional, Advisory Board: AstraZeneca; Financial Interests, Institutional, Advisory Board: Bayer; Financial Interests, Institutional, Advisory Board: Janssen; Financial Interests, Institutional, Advisory Board: Sanofi; Financial Interests, Institutional, Advisory Board: Seattle Genetics; Financial Interests, Institutional, Advisory Board: Genentech. T.E. Hutson: Financial Interests, Institutional, Advisory Role: Astellas; Financial Interests, Institutional, Advisory Board: Aveo; Financial Interests, Institutional, Advisory Board: Bristol Myers Squibb; Financial Interests, Institutional, Advisory Board: Eisai; Financial Interests, Institutional, Advisory Board: EMD Serono; Financial Interests, Institutional, Advisory Board: Exelixis; Financial Interests, Institutional, Advisory Board: Janssen; Financial Interests, Institutional, Advisory Board: Merck; Financial Interests, Institutional, Advisory Board: Novartis; Financial Interests, Institutional, Advisory Board: Pfizer. E.J. Drea: Financial Interests, Personal, Stocks/Shares, Employed by Sanofi: Sanofi-Genzyme. N.J. Vogelzang: Financial Interests, Institutional, Advisory Board: Aveo; Financial Interests, Institutional, Advisory Board: Celgene; Financial Interests, Institutional, Advisory Board: Dendreon; Financial Interests, Institutional, Advisory Board: Exelixis; Financial Interests, Institutional, Advisory Board: Novartis; Financial Interests, Institutional, Advisory Board: OncoGene; Financial Interests, Institutional, Advisory Board: Veridex; Financial Interests, Institutional, Invited Speaker: Caris Life Scinecnes; Financial Interests, Institutional, Invited Speaker: Eli Lilly; Financial Interests, Institutional, Invited Speaker: Novartis; Financial Interests, Institutional, Invited Speaker: Sanofi. All other authors have declared no conflicts of interest.