TROPIC, a large, multinational study, showed that cabazitaxel was superior to mitoxantrone in men with metastatic castration-resistant disease that did not respond to prior treatment with docetaxel.

SAN FRANCISCO—Cabazitaxel, a novel taxane, prolongs survival better than mitoxantrone in patients with metastatic castration-resistant prostate cancer (mCRPC) and who had failed previous treatment with docetaxel, according to new findings from a phase 3 trial presented here today at the Genituourinary Cancers Symposium.

The finding is based on the TROPIC study, which included 755 men with mCRPC at 132 centers in 26 countries. Investigators randomly assigned subjects to receive treatment with 10 mg/day of prednisone and either cabazitaxel 15 mg/m2 or mitoxantrone 12 mg/m2. Patients had a median follow-up of 12.8 months.

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The median survival in the cabazitaxel group was 15.1 months compared with 12.7 months in the mitoxantrone-treated patients, according to lead investigator A. Oliver Sartor, MD, the Gerald & Flora Jo Mansfield Piltz Endowed Professor in Cancer Research at Tulane Cancer Center in New Orleans. The cabazitaxel group had a 30% decreased risk of death compared with the mitoxantrone arm, in addition to significantly better progression-free survival (a composite of tumor, PSA, or pain progression, or death).

The most frequent grade 3/4 toxicity was neutropenia, which occurred in 81.7% of cabazitaxel-treated patients compared with 58% of mitoxantrone recipients. Rates of febrile neutropenia were 7.5% and 1.3%, respectively.