Meeting Abstract | 2013 Quality Care Symposium


Background: Cabazitaxel (C) and abiraterone (A) improve survival in mCRPC after progression on docetaxel (D). We examined whether mCRPC patients progressing on D received C and/or A, in which sequence, and how they compared with patients not receiving C or A. Methods: This retrospective study used medical records from the ACORN Data Warehouse. Eligible patients were: diagnosed with mCRPC, progressed after 1st-line D, treated 2nd-line with C (DC) or A (DA). Some went to 3rd-line C or A (DCA, DAC). A random sample of comparable patients without A or C (DO) was included. Demographic and clinical characteristics were extracted. Cox regression analyses assessed PFS and OS by 2nd-line group after D. Results: Screened out patients were: 60 with no progression on D; 41 absent records; 18 with another cancer. Table below shows patients by treatment sequence group. Age, PS, and PSA did not differ significantly. More patients appear to have received A after C (56.7%) than C after A (25.7%). In the 3-drug sequence groups, more patients received DCA in the 6-month period from April-October 2011 (n = 17/19) than in the 6-month period from June-December 2012 (n = 2/10), suggesting a drop-off in use of C immediately after D. Cox PFS treatment effect was not significant. Cox OS treatment effect was significant (DA vs DC, HR = 1.693 [95% CI: 1.066, 2.691], p = 0.0258). Conclusions: Patterns suggest comparable outcomes in PFS. Controlling for patient characteristics, OS may be longer in DC vs DA. Patients appear undertreated in third line with fewer receiving C after A than the opposite sequence. We hypothesize that DAC may not be as feasible as DCA. Reasons for underutilization of C are being examined.

Patient demographic and clinical characteristics.*

Characteristic DC
n = 60
n = 71
n = 34
n = 18
n = 129
n= 260
Age (median years) 68.97 70.83 68.88 67.00 68.95 69.47
PS, n (%) impaired vs. not indicated impaired 8 (13.33) 12 (16.90) 5 (14.71) 3 (16.67) 16 (12.4) 36 (13.85)
PSA ng/mL (n) 49 50 27 14 95 194
Median 221.00 82.00 264.80 67.50 111.00 111.95

Abbreviations: A, abiraterone; C, cabazitaxel; and D, docetaxel.

*Baseline characteristics assessed end of D. DCA and DAC are subsets of DC and DA.

© 2013 by American Society of Clinical Oncology


No companion articles


DOI: 10.1200/jco.2013.31.31_suppl.118 Journal of Clinical Oncology 31, no. 31_suppl (November 01, 2013) 118-118.

Published online November 01, 2013.

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