Multicenter randomized phase 2 trial of abiraterone acetate with or without cabazitaxel for metastatic castration-resistant prostate cancer

Improving clinical outcomes with novel drug combinations for metastatic castration-resistant prostate cancer (mCRPC) is challenging. A multicenter phase 2 trial in the USA randomized patients with previously untreated mCRPC to upfront abiraterone acetate/prednisone plus cabizataxel (AAP + C) or AAP followed by C upon radiographic progression. Both treatments were well-tolerated. Upfront AAP + C resulted in improved rPFS, OS, and proportion of patients with at least 50% PSA decline when compared to the sequential treatment. The authors conclude that AAP + C given earlier rather than sequentially may benefit some patients with mCRPC. Further work is needed to identify this population.