Indications
Cabazitaxel is an anticancer medicine used, together with Prednisolone or Prednisone, to treat prostate cancer that has spread and no longer responds to hormone (testosterone lowering) treatment, usually after earlier treatment with Docetaxel.
How It Works
Cabazitaxel belongs to the taxane group. It binds to microtubules, tiny fibres inside cells that pull chromosomes apart when a cell divides, and locks them in place. Cancer cells then cannot complete division and die. It is designed to work even in some tumours that have become resistant to Docetaxel.
Dosage and Administration
Cabazitaxel is given as prescribed by a cancer specialist, as a drip into a vein (infusion) by a doctor or nurse in hospital, usually once every 3 weeks. The dose is based on body surface area and is adjusted for blood counts, liver function and side effects. Before each infusion, medicines are given to reduce the risk of allergic reactions, and a steroid tablet is taken daily as prescribed.
Interactions
- Strong CYP3A blockers such as Ketoconazole, Clarithromycin and Ritonavir, and grapefruit juice, can raise cabazitaxel levels and should be avoided.
- Strong CYP3A inducers such as Rifampicin, Carbamazepine, Phenytoin and St John’s wort can lower its levels.
- Live vaccines, especially yellow fever vaccine, must not be given during treatment.
Contraindications
- Severe allergy to cabazitaxel or to Polysorbate 80, an ingredient of the infusion.
- Low neutrophil count (a type of white blood cell) before treatment.
- Severe liver impairment.
- Recent or planned yellow fever vaccination.
Side Effects
Very common: low white cells, red cells and platelets, tiredness, diarrhoea, nausea, vomiting, constipation, loss of appetite, taste changes, back and joint pain, and blood in the urine. Other effects: fever with low white cells (febrile neutropenia), severe diarrhoea with dehydration, numbness or tingling of the hands and feet, hair loss, kidney problems and allergic reactions during the infusion.
Get urgent medical help for fever of 38°C or more, chills, severe or persistent diarrhoea or vomiting, dizziness or fainting, bleeding, black stools, breathing difficulty, swelling of the face or a rash during or after the infusion, or severe stomach pain.
Pregnancy and Lactation
Cabazitaxel is used only in men. It can harm an unborn baby, so men should use condoms and effective contraception with a female partner during treatment and for some months afterwards, as advised by the doctor. It may reduce male fertility.
Precautions and Warnings
Used only under the supervision of specialists in cancer treatment. Blood counts are checked before each cycle and often during treatment; medicines to support white cells may be given. Drink plenty of fluids, and start anti diarrhoea treatment and contact your team promptly if diarrhoea occurs. Older people and those with kidney, liver or lung problems need closer monitoring.
Overdose
Overdose is expected to cause severe bone marrow suppression and severe stomach and bowel effects. It is managed in hospital with close monitoring and supportive care, such as white cell growth factors, fluids and antibiotics.
Therapeutic Class
Antineoplastic, taxane
Storage
Hospital and specialist medicine: store as directed on the pack, out of the reach of children. Cytotoxic waste must be handled and disposed of safely.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.