From the Guidelines
Cabozitaxel is typically dosed at 20 mg/m² administered as a 1-hour intravenous infusion every 3 weeks for metastatic castration-resistant prostate cancer, as this dose has been shown to be noninferior to the higher dose of 25 mg/m² in terms of overall survival, with decreased grade 3/4 adverse events 1. The dosing of cabozitaxel is crucial in managing metastatic castration-resistant prostate cancer, and the choice of dose depends on various factors, including the patient's overall health and ability to tolerate the medication.
- Key considerations for dosing cabozitaxel include:
- Starting dose: 20 mg/m²
- Administration: 1-hour intravenous infusion every 3 weeks
- Dose modification: may be necessary for patients with hepatic impairment or significant toxicities
- Concomitant medication: must be administered with concurrent steroids, such as daily prednisone or dexamethasone on the day of chemotherapy The PROSELICA study compared the two doses of cabozitaxel, 20 mg/m² and 25 mg/m², and found that the lower dose was noninferior to the higher dose in terms of overall survival, with decreased grade 3/4 adverse events, including grade ≥3 neutropenia 1.
- The benefits of using the lower dose of 20 mg/m² include:
- Decreased risk of grade 3/4 adverse events
- Decreased risk of grade ≥3 neutropenia
- Noninferior overall survival compared to the higher dose It is essential to carefully monitor patients receiving cabozitaxel, particularly for signs of neutropenia and diarrhea, and to adjust the dose or discontinue treatment as necessary to minimize the risk of significant toxicities 1.
From the Research
Cabozantinib Dosing
There is no information on cabozitaxel dosing in the provided studies. However, the studies do provide information on the dosing of cabozantinib, which is a different medication.
- The dosing of cabozantinib varies across different studies, with doses ranging from 20 mg to 100 mg per day 2, 3, 4.
- In some studies, cabozantinib was administered at a dose of 60 mg per day, with reductions to 40 mg or 20 mg in patients experiencing adverse events 5, 3.
- The dosing of cabozantinib may also depend on the specific patient population and the disease being treated, such as metastatic renal cell carcinoma or castration-resistant prostate cancer 5, 3, 4.
Dosing in Specific Patient Populations
- In patients with metastatic renal cell carcinoma, cabozantinib was administered at a dose of 60 mg per day, with reductions to 40 mg or 20 mg in patients experiencing adverse events 5, 3.
- In patients with castration-resistant prostate cancer, cabozantinib was administered at a dose of 100 mg per day 4.
- In patients with metastatic castration-resistant prostate cancer, cabozantinib was combined with docetaxel and prednisone, with a maximum tolerated dose of 40 mg per day 2.
Note: There are no research papers to assist in answering the question of how cabozitaxel is dosed.