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Cabazitaxel

Brand names: JEVTANA

Therapeutic Indications

Cabazitaxel is indicated for:

Prostate cancer

Men inly, only Adults (18 years old or older)

Cabazitaxel in combination with prednisone or prednisolone is indicated for the treatment of adult patients with metastatic castration resistant prostate cancer previously treated with a docetaxel-containing regimen.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Intravenous - 25 mg/m² once

Contraindications

Active ingredient Cabazitaxel is contraindicated in the following cases:

Severe hepatic impairment (total bilirubin >3 x ULN)

No gender/age discrimination

Cabazitaxel should not be given to patients with severe hepatic impairment (total bilirubin >3 x ULN).

Yellow fever vaccine

No gender/age discrimination

Concomitant vaccination with yellow fever vaccine.

Neutropenia

No gender/age discrimination

Patients treated with cabazitaxel may receive prophylactic G-CSF, as per American Society of Clinical Oncology (ASCO) guidelines and/or current institutional guidelines, to reduce the risk or manage neutropenia complications (febrile neutropenia, prolonged neutropenia or neutropenic infection). Primary prophylaxis with G-CSF should be considered in patients with high-risk clinical features (age >65 years, poor performance status, previous episodes of febrile neutropenia, extensive prior radiation ports, poor nutritional status, or other serious comorbidities) that predispose them to increased complications from prolonged neutropenia. The use of G-CSF has been shown to limit the incidence and severity of neutropenia.

Neutropenia is the most common adverse reaction of cabazitaxel. Monitoring of complete blood counts is essential on a weekly basis during cycle 1 and before each treatment cycle thereafter so that the dose can be adjusted, if needed.

The dose should be reduced in case of febrile neutropenia, or prolonged neutropenia despite appropriate treatment. Patients should be re-treated only when neutrophils recover to a level ≥1,500/mm³.