II. Indications

  1. Prostate Cancer (Hormone-refractory, metastatic)

III. Contraindications

  1. Impaired Hepatic Function
  2. QTc Prolongation

IV. Mechanism

  1. See Mitotic Inhibitor Chemotherapy
  2. Cabazitaxel is a taxane Antimitotic Agent with antineoplastic agent
    1. Semi-synthetic derivative of the natural taxoid, 10-deacetylbaccatin 3
  3. Cabazitaxel binds tubulin
    1. Inhibits microtubule depolymerization
    2. Inhibits cell division, arresting the cell cycle in G2/M phase
    3. Inhibits tumor cell proliferation
  4. Cabazitaxel is unique among Taxanes
    1. Binds poorly to the P-Glycoprotein efflux pump (potential activity against mutidrug resistant tumors)
    2. Penetrates the blood brain barrier

V. Medications

  1. Cabazitaxel Intravenous Solution: 60 mg in 1.5 ml vial (dilute in 5.7 ml supplied diluent)

VI. Dosing

  1. See other references for disease specific dosing protocols
  2. Prostate Cancer (Hormone-refractory, metastatic)
    1. Cabazitaxel 25 mg/m2 IV every 3 weeks AND
    2. Prednisone 10 mg orally daily for entire treatment course
  3. Premedicate each dose (30 minutes prior)
    1. Dexamethasone 8 mg or equivalent AND
    2. Antihistamine and H2 Blocker

VII. Adverse Effects

  1. Myelosuppression (Bone Marrow Suppression)
    1. Neutropenia (severe)
  2. Hypersensitivity Reaction (severe)
  3. Diarrhea (severe)
  4. Pulmonary effects
    1. Pneumonitis
    2. Interstitial Lung Disease
    3. Acute Respiratory Distress Syndrome

VIII. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count

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