Alicia Morgans, MD, MPH, Discusses Differences in Complications and Costs With Cabazitaxel vs a Second Androgen Receptor Targeted Agent in mCRPC

At the 2021 European Society of Medical Oncology, CancerNetwork® spoke with Alicia Morgans, MD, MPH, Medical Director of Survivorship at Dana-Farber Cancer Center, about key differences in complications and hospital stays for patients with metastatic castration-resistant prostate cancer who were treated with cabazitaxel (Jevtana) or a second androgen receptor targeted agent such as enzalutamide (Xtandi) or abiraterone (Zytiga), as seen in the phase 4 CARD trial (NCT02485691).

Transcript:

I was very impressed by the actual differences in complications and hospitalization days. I think we intuitively understand that if we use medications that provide better cancer control, as long as they’re not causing such harm that patients aren’t able to tolerate them and have to discontinue the medications, we usually are going to see better outcomes; that can be shown in a clinical trial, but in a hypothetical cohort like this, we can actually see those things quantified. The number of hospitalization days [were] dramatically different and [were] reduced with patients getting that effective treatment with cabazitaxel vs what is essentially a not very effective treatment—when patients get a second-line androgen receptor–targeted agent. That I thought was very impressive.

The differences in progression-free survival are also very different, favoring cabazitaxel as compared to the secondary targeted agent. When we look in real dollars, we can see that these events have consequences. From a health economics perspective, and health resource utilization perspective, cabazitaxel was associated with lower cost. [This is] because, of course, we’re having less hospitalization, we’re having less skeletal related events, and patients are staying well longer. It was surprising in the extent that the difference occurred, but also really reassuring that the basic principles of maintaining disease control in patients with cancer can improve their outcomes in these real and meaningful ways.

Reference

Morgans AK, Hutson TE, Guan AK, et al. 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). Presented at: 2021 European Society of Medical Oncology Congress; September 16-21, 2021; Virtual. Abstract 587P.