The drug is called Cabazitaxel, (it will be named Jevtana) and is made by the French company Sanofi-Aventis SA. Cabazitaxel is a chemical cousin of Taxotere (the current standard of care) and it is designed to evade the mechanism that cancer cells use to resist Taxotere, so we can assume that initially it would be used after Taxotere failure. Currently, once Taxotere has failed, we do not have an approved alternate therapy other than perhaps going back the older and much more toxic drug mitoxantrone.
The results of a small phase III study of only 755 men from several dozen countries demonstrated that Cabazitaxel extended life when compared against mitoxantrone by 30%, or an extra 10 weeks. Men in the Cabazitaxel group lived a little more than 15 months on average, versus less than 13 months for those given mitoxantrone. Men in both trial groups were also given prednisone, which eases pain and improves appetite.
Serious side effects were more common with Cabazitaxel — 57 percent suffered them versus 39 percent for the mitoxantrone. Most common were severely low white blood cell counts, diarrhea, nausea and fatigue.
As with all new drugs being tested the men in the trial could be described as men who were in the very end stage of the disease. The company has said that they hope it will do better when tested in men who aren’t as sick.
The federal Food and Drug Administration (FDA) has said it will give it a quick review; however this does not mean that the drug will come on the market in a quickly.
The study was lead by Dr. Oliver Sartor of New Orleans’ Tulane University. Dr Sartor said the results of the study will be presented Friday at a meeting of the American Society of Clinical Oncology and several other groups. The study was sponsored by Sanofi, and most of the researchers work or consult for the firm.
On the surface Cabazitaxel is clearly not a miracle drug, but increasingly it has become clear that the best treatment for advanced prostate cancer will be a cocktail of drugs similar to the type of treatment protocol we use for the treatment of HIV, Perhaps Cabazitaxel will have a place in the future protocol.
Joel T Nowak, MA, MSW
Nobody saw this coming. If you were healthy then this destroys your quality of life and if you are beat down this makes you wish for redemption. Over treatment, anyone?