Alicia Morgans, MD, MPH, discusses a health economics analysis presented at the 2021 ESMO Congress that assessed the clinical and cost impact of cabazitaxel (Jevtana) versus a second-androgen receptor targeted agent (ARTA) for patients with metastatic castration-resistant prostate cancer (mCRPC) previously treated with docetaxel and the alternative ARTA (abiraterone acetate [Zytiga] or enzalutamide [Xtandi]).1 Morgans and coinvestigators based their analysis on data from 100 patients treated in this setting, with inputs from the CARD trial, medical literature, and estimates (by 3 GU oncologists) of typical clinical care patterns.
As point of reference, the results of the CARD trial previously showed that third-line cabazitaxel (post docetaxel and after 1 year of abiraterone or enzalutamide) significantly improved progression-free survival (PFS; HR, 0.54; P <.001) and overall survival (OS; HR, 0.64; P =.008).2 The use of cabazitaxel also showed a clinically meaningful improvement in pain response and time to skeletal-related events versus abiraterone or enzalutamide.2
In their ESMO abstract conclusion, Morgans et al wrote that their health economic analysis showed that, “The use of cabazitaxel as a third-line treatment after docetaxel and ARTA in mCRPC pts is predicted to result in clinical benefits (longer rPFS, OS) and fewer hospitalization and ICU days. Compared to a second ARTA, cabazitaxel was estimated to be associated with a 21% reduction in both symptomatic skeletal event and end-of-life care costs and a 10% increase in adverse event costs, for an overall decrease of 17% in costs.”1
Morgans is a genitourinary medical oncologist and the medical director of the Survivorship Program at Dana-Farber Cancer Institute.
1. 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.
2. de Wit R, de Bono J, Sternberg CN, et al. Cabazitaxel versus abiraterone or enzalutamide in metastatic prostate cancer. N Engl J Med. 2019;381(26):2506-2518. doi: 10.1056/NEJMoa1911206