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Cabozantinib not superior to mitoxantrone-prednisone for pain relief in mCRPC

24 May 2019

Cabozantinib is not better than mitoxantrone-prednisone at relieving pain in patients with metastatic castration-resistant prostate cancer (mCRPC) with symptomatic bone metastasis, a recent study suggests.

Researchers randomly assigned 119 mCRPC patients to receive 60 mg oral cabozantinib once-daily (n=61; median age, 65.0 years) or 12 mg/m2 mitoxantrone every 3 weeks with 5 mg oral prednisone twice-daily (n=58; median age, 66.0 years). Six-week pain response, measured using the Brief Pain Inventory and validated at week 12, was the primary efficacy endpoint.

In the intention-to-treat population, no significant difference in pain response was observed between the cabozantinib and mitoxantrone-prednisone groups (15 percent vs 17 percent; difference, –2 percent; 95 percent CI, –16 to 11; p=0.8). The same trend was obtained when pain scores were considered as continuous variables (difference between the means, 4.6 percent; –7.8 to 17).

However, bone scan response was significantly greater in patients who received cabozantinib (31 percent vs 5.2 percent; difference, 26 percent; 13–39).

There were no significant between-group differences observed in median overall survival (cabozantinib vs mitoxantrone-prednisone: 9.0 vs 7.9 months; stratified hazard ratio [HR], 0.70; 0.44–1.10) and progression-free survival (2.9 vs 2.8 months; stratified HR, 0.74; 0.41–1.34).

All patients experienced at least one adverse event (AE). Grade 3/4 AEs were common in either group: 70 percent for the cabozantinib and 67 percent for the mitoxantrone-prednisone groups. A similar pattern was observed for serious AEs, which were present in 72 percent and 61 percent of patients in the respective groups.

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Most Read Articles
3 days ago
Monotherapy with tenofovir disoproxil fumarate increases virologic response for up to 240 weeks in pretreated patients with hepatitis B virus infection (HBV) who are resistant to entecavir and/or adefovir, a new study has found.
Elvira Manzano, 3 days ago
Long-term treatment with the interleukin-5 receptor alpha-directed cytolytic monoclonal antibody benralizumab led to long-term control of asthma, improvement in pulmonary function, and was safe in patients with severe eosinophilic asthma in the 2-year integrated analysis of the SIROCCO, CALIMA, and ZONDA pivotal studies plus the BORA extension study reported at ATS 2019.
Pearl Toh, 21 hours ago
Patients with rheumatoid arthritis (RA) who maintained their disease remission had a significantly reduced risk of clinical and subclinical atherosclerosis, according to the 3-year follow-up data of the GIRRCS* study presented at EULAR 2019.
2 days ago
Duodenal eosinophilia carries up to a sixfold increased risk of developing gastro-oesophageal reflux disease (GERD) over 10 years in individuals with functional dyspepsia (FD) and postprandial distress syndrome (PDS), a study has found.