Multicenter retrospective cohort study of docetaxel rechallenge versus cabazitaxel in patients with metastatic castration-resistant prostate cancer

Docetaxel has been a standard treatment for metastatic castration-resistant prostate cancer (mCRPC) since 2004. Cabazitaxel was approved in 2010 for patients with mCRPC who had been previously treated with docetaxel. A multicenter retrospective cohort study in the USA compared docetaxel rechallenge versus switching to cabazitaxel in mCRPC patients who did not experience disease progression during prior administration of docetaxel in the mCRPC setting. The study included 669 patients (407 receiving cabazitaxel and 262 receiving docetaxel rechallenge). The primary outcome was overall survival (OS) from the initiation of the second course of taxane. The median OS was significantly longer with docetaxel rechallenge compared with cabazitaxel (12.3 versus 9.6 months; HR 0.81; p=0.04). Descriptive analysis of secondary outcomes was consistent with this finding, including PSA response (weighted 9.8% achieving reduction of 90% or more in the docetaxel rechallenge group versus 3.0% in the cabazitaxel group) and median time to next treatment or death (median 10.7 versus 8.9 months). Use of platinum, immunotherapy, or PARP inhibitors was similar between the two groups. The authors conclude that these findings support docetaxel rechallenge as a treatment option for patients in this scenario.