Optimizing Patient Selection for Cabazitaxel Therapy in Metastatic CRPC


A brief review of factors that may influence an academic or community physician’s choice to utilize cabazitaxel in the setting of metastatic castration-resistant prostate cancer.


Elisabeth Heath, MD, FACP: Do you think we’re looking at this similarly because we both practice in an academic setting? How do you think your community colleagues are embracing this change?

Tanya Dorff, MD: I see a mix of patients. We are a big clinical trials referral center but I can still detect the practice patterns. Some doctors will just use the [cabazitaxel] because they’re really comfortable with it. They’re confident it’s going to help and they believe it’s beneficial. So, they’re going to do that. Then I have other doctors where you can tell they’re a little bit more on the fence, and they’ll send [patients] to me, saying, “I can give this person cabazitaxel, but do you have a clinical trial?” Which is, of course, something we love to see. But I do wonder if that reflects a lower enthusiasm. So, I think there is probably mixed usage in the community. How about in Michigan?

Elisabeth Heath, MD, FACP: Same thing. I think there is an interesting evolution. A lot of our community physicians are within our large Karmanos [Karmanos Cancer Institute, Detroit, Michigan]network. As health care evolves as a business model, I think there’s a standard of care in Detroit headquarters. But a lot of the other doctors who are still within the Karmanos cancer institute umbrella are used to the way they have been doing things. So, yes, they’re aware of the data, but there’s that comfort level, like, “OK, I’ve been doing it this way. My staff knows how to handle it. My nurses know how to handle it. So, this is what we’re going to do. Although clinical trial is great and if it opened at our site, I would love it, but I’m 5 hours away, so I’m not going to be able to, in the middle of winter, send my patient.” I think all of those factors impact whether you’re going to do a trial or not in real life. I think that’s where, in a way, the more trials we can open in their backyard, if you will, the easier it will be. But you and I know that’s a little more complicated than it should be.

Tanya Dorff, MD: Yes, and I agree, some patients can’t access the academic center and join a clinical trial. So we do send them back [to their physician] and say cabazitaxel is a great choice.

Transcript edited for clarity.

Related Videos
Dan S. Childs, MD, medical oncologist, Mayo Clinic
Neal Shore, MD, FACS, discusses current and ongoing research with radioligand therapy in patients with nonmetastatic castration-sensitive prostate cancer.
Corey Cutler, MD, MPH, and Hana Safah, MD, experts on GvHD
Corey Cutler, MD, MPH, and Hana Safah, MD, experts on GvHD