Third-Line Jevtana Improves Progression-Free Survival in Prostate Cancer Subtype


"Sequential treatment in prostate cancer is really something that’s evolving over time," Dr. Daniel Petrylak said of the study findings presented at the European Society of Medical Oncology Congress 2019.

Third-line treatment with Jevtana (cabazitaxel) improved survival among patients with metastatic castration-resistant prostate cancer, according to findings from the CARD trial.

At the European Society of Medical Oncology (ESMO) Congress 2019, CURE spoke with Dr. Daniel Petrylak, professor of medicine and urology at Yale Cancer Center, about these findings and what they mean for the metastatic castration-resistant prostate cancer treatment landscape.


Sequential treatment in prostate cancer is really something that’s evolving over time. We don’t really have an algorithm to help us determine what’s the right drug to use in a given situation.

So, the CARD trial looked at those patients who received docetaxel and at least one second-generation anti-androgen as prior treatment, and they were randomized to receive cabazitaxel or a second-generation anti-androgen such as [Xtandi (enzalutamide)].

And what was found from the study was that there was a better progression-free survival in those patients who received cabazitaxel versus those patients who received the next-generation agent, suggesting that there still is some resistance to the hormonal agents, whether that be through AR-V7 or other mechanisms.

One of the thoughts had been that perhaps, if you treated a patient with chemotherapy such as docetaxel, and they’ve received [Zytiga (abiraterone)] or enzalutamide, that those patients may be re-sensitized in that situation, because of the fact that you can knock out the clones that are AR-V7-positive with docetaxel.

This is actually going against that particular hypothesis and it’s showing that chemotherapy after next-generation androgen docetaxel is the way to go.

Related Videos
Image of a woman with short brown hair and glasses.
Image of a man with brown hair and a suit and tie.
Image of a woman with brown bobbed hair with glasses.
Image of Dr. Minesh Mehta at ASCO 2024.
Image of a woman with blond hai
Image of a man with rectangular glasses and short dark hair.
Jessica McDade, B.S.N., RN, OCN, in an interview with CURE
For patients with cancer, the ongoing chemotherapy shortage may cause some anxiety as they wonder how they will receive their drugs. However, measuring drugs “down to the minutiae of the milligrams” helped patients receive the drugs they needed, said Alison Tray. Tray is an advanced oncology certified nurse practitioner and current vice president of ambulatory operations at Rutgers Cancer Institute in New Jersey.  If patients are concerned about getting their cancer drugs, Tray noted that having “an open conversation” between patients and providers is key.  “As a provider and a nurse myself, having that conversation, that reassurance and sharing the information is a two-way conversation,” she said. “So just knowing that we're taking care of you, we're going to make sure that you receive the care that you need is the key takeaway.” In June 2023, many patients were unable to receive certain chemotherapy drugs, such as carboplatin and cisplatin because of an ongoing shortage. By October 2023, experts saw an improvement, although the “ongoing crisis” remained.  READ MORE: Patients With Lung Cancer Face Unmet Needs During Drug Shortages “We’re really proud of the work that we could do and achieve that through a critical drug shortage,” Tray said. “None of our patients missed a dose of chemotherapy and we were able to provide that for them.” Tray sat down with CURE® during the 49th Annual Oncology Nursing Society Annual Congress to discuss the ongoing chemo shortage and how patients and care teams approached these challenges. Transcript: Particularly at Hartford HealthCare, when we established this infrastructure, our goal was to make sure that every patient would get the treatment that they need and require, utilizing the data that we have from ASCO guidelines to ensure that we're getting the optimal high-quality standard of care in a timely fashion that we didn't have to delay therapies. So, we were able to do that by going down to the minutiae of the milligrams on hand, particularly when we had a lot of critical drug shortages. So it was really creating that process to really ensure that every patient would get the treatment that they needed. For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.
Related Content