Subanalysis of TROPIC Trial: Cabazitaxel plus Prednisone versus Mitoxantrone after Docetaxel in Patients with Different Prognostic Risk Factors

Conference Correspondent - ESMO 2014 - Prostate Cancer

Previous results of the TROPIC trial showed that patients with metastatic castrate-resistant prostate cancer (mCRPC) who were treated with cabazitaxel plus prednisone (CP) had improved overall survival (OS) compared with patients who received mitoxantrone plus prednisone (MP; Bahl A, et al. Ann Oncol. 2013;24:2402-2408; Oudard S. Future Oncol. 2011;7:497-506).

At ESMO 2014, Heidenreich and colleagues presented the results of a new subanalysis of the TROPIC trial (Heidenreich A, et al. ESMO 2014: Abstract 771P) to evaluate the effect of CP versus MP therapy in patients with mCRPC based on whether they had 9 poor prognostic risk factors, including pain, measurable disease, measurable visceral disease, ECOG performance status 2 vs 0 or 1, time since last docetaxel therapy (?6 vs >6 months), time from first hormone therapy (?3.6 vs >3.6 years), hemoglobin level (<120 vs ?120 g/L), prostate-specific antigen, and alkaline phosphatase (>133 vs ?133 IU/L).

Of the 597 patients included in the TROPIC trial, 439 had prognostic factor data available. As shown in the Table, patients treated with CP consistently showed significant improvement in median OS compared with those treated with MP, regardless of the number of poor prognostic factors they had. The investigators concluded that although increasing numbers of poor prognostic factors were associated with a worsening OS, the use of CP therapy improved OS compared with MP, regardless of the number of poor prognostic factors present.