# Cabazitaxel

Source: https://onco.cc/drugs/cabazitaxel/  
OnCo record `cabazitaxel` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A second taxane that works after docetaxel and beat a second hormone pill head-to-head (CARD).

## Summary

Cabazitaxel is a taxane with low affinity for the P-glycoprotein efflux pump, so it remains active in docetaxel-resistant disease. It is used in metastatic castration-resistant prostate cancer after docetaxel, with neutropenia as its main toxicity. TROPIC (2010) showed an overall survival benefit after docetaxel, and CARD (2019) showed it was superior to switching to a second androgen receptor pathway inhibitor in men who had already had one ARPI and docetaxel. It served as the comparator in TheraP, where it lost to 177Lu-PSMA-617 on PSA50 response (66% versus 37%) although overall survival was similar (HR 0.97), and in XALute against the T-cell engager xaluritamig. Its place relative to radioligands and T-cell engagers is therefore still being worked out. For a newcomer, it is the second taxane that works after docetaxel and beat a second hormone pill head-to-head.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-06
- Brand: Jevtana
- Modality: Cytotoxic chemotherapy (taxane)
- Mechanism: Taxane with low P-glycoprotein affinity, active in docetaxel-resistant disease.
- Approvals: US 2010: mCRPC after docetaxel

## Notes

- NICE TA391 recommends cabazitaxel with prednisone or prednisolone for metastatic hormone-relapsed prostate cancer that has progressed during or after docetaxel, only if the person has an ECOG performance status of 0 or 1, has had at least 225 mg/m2 of docetaxel, and stops treatment at progression or after a maximum of 10 cycles, with the commercial arrangement in place. PROSELICA showed that 20 mg/m2 is non-inferior to 25 mg/m2 for overall survival (13.4 against 14.5 months) with grade 3 or 4 adverse events in 39.7 against 54.5 percent, which is the basis for starting an older or frailer man on the lower dose.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Cabazitaxel
- FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Cabazitaxel
- NICE TA391: cabazitaxel for hormone-relapsed metastatic prostate cancer treated with docetaxel: https://www.nice.org.uk/guidance/ta391
- PROSELICA (Journal of Clinical Oncology 2017): https://doi.org/10.1200/JCO.2016.72.1076

## Connected records

- cancers: [Metastatic castration-resistant prostate cancer](https://onco.cc/cancers/prostate-mcrpc/), [Neuroendocrine and small-cell prostate cancer](https://onco.cc/cancers/prostate-nepc/), [Prostate cancer](https://onco.cc/cancers/prostate/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Nails after chemotherapy: lifting, ridges and discolouration](https://onco.cc/technologies/nail-changes-after-chemotherapy/), [Scalp cooling (cold caps: DigniCap, Paxman)](https://onco.cc/technologies/scalp-cooling/)
- companies: [Sanofi](https://onco.cc/companies/sanofi/)
- terms: [Drug efflux pumps (ABC transporters)](https://onco.cc/terms/efflux-pump/), [Prostate cancer drugs in England: what NICE recommends, and what it refuses](https://onco.cc/terms/prostate-uk-drug-approvals/), [What follows what in castration-resistant prostate cancer](https://onco.cc/terms/prostate-crpc-sequencing/)
- trials: [A Study of Xaluritamig Plus Abiraterone Versus Investigator's Choice in Participants With Chemotherapy-naïve Metastatic Castration-resistant Prostate ](https://onco.cc/trials/nct07213674/), [AFFINITY](https://onco.cc/trials/affinity-custirsen/), [AZD2265 Compared With Standard of Care in PSMA-positive Metastatic Castration-resistant Prostate Cancer (VECTRA-01)](https://onco.cc/trials/nct07611110/), [CARD](https://onco.cc/trials/card/), [FIRSTANA](https://onco.cc/trials/firstana/), [PROSELICA](https://onco.cc/trials/proselica/), [Substudy 01A: Safety and Efficacy of Opevesostat (MK-5684)-Based Treatment Combinations or Opevesostat Alone in Participants With Metastatic Castration-resistant Prostate Cancer (mCRPC) (MK-5684-01A)](https://onco.cc/trials/nct06353386/), [TheraP (ANZUP 1603)](https://onco.cc/trials/therap/), [TROPIC](https://onco.cc/trials/tropic/), [XALute](https://onco.cc/trials/xalute/)
- key papers: [TROPIC: prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel](https://onco.cc/key-papers/paper-de-bono-tropic-cabazitaxel-lancet-2010/)
- ideas: [Randomise the order of treatment, not only the drugs: a strategy platform for metastatic prostate cancer](https://onco.cc/ideas/idea-prostate-randomise-the-sequence-not-only-the-drugs/)
- pathways: [Mitosis & the spindle assembly checkpoint](https://onco.cc/pathways/mitotic-spindle-checkpoint/)

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