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Treatment Name: Cabazitaxel (Jevtana®) + Prednisone

Cabazitaxel (Jevtana®) + Prednisone is a Chemotherapy Regimen for Prostate Cancer

How does Cabazitaxel with prednisone work?
Cabazitaxel is designed to kill cancer cells by decreasing their ability to divide into more cells. Prednisone is taken with cabazitaxel as part of the chemotherapy regimen to possibly slow the growth of cancer cells and reduce side effects from chemotherapy.

Goals of therapy:
Cabazitaxel is given to shrink the tumor and decrease symptoms associated with metastatic prostate cancer. Cabazitaxel with prednisone is commonly given with the goal of improving survival in men with prostate cancer, but usually not with the goal of cure.

Schedule

  • Cabazitaxel intravenous (I.V.) infusion over one hour on Day 1
  • Prednisone by mouth once daily continuously

Estimated total infusion time for this treatment:

  • Up to 1.5 hours for Cycle 1, Day 1
  • Infusion times are based on clinical studies, but may vary depending on doctor preference or patient tolerability. Pre-medications and intravenous (I.V.) fluids, such as hydration, may add more time

Cabazitaxel is usually given in an outpatient infusion center, allowing the person to go home afterwards. Prednisone is then usually taken at home on Days 1-21.

Cabazitaxel is repeated every 21 days. This is known as one Cycle. Each cycle may be repeated until there is disease progression or unacceptable toxicity. Duration of therapy may be up to 10 cycles or indefinitely depending upon response, tolerability, and number of cycles prescribed.

Click here for common starting doses.

Side Effects

In a multi-drug regimen, each medication has unique side effects. When these medicines are given together, drug-related side effects reported in clinical studies give the best estimate of what to expect. In clinical studies, the most commonly reported side effects with Cabazitaxel with prednisone are shown here:

Roughly 18% of patients discontinue cabazitaxel due to unacceptable side effects.

Side effect videos Side Effect Videos
AnemiaAnemiaBleedingBleedingDiarrheaDiarrheaFatigue Fatigue Nausea and VomitingNausea and VomitingConstipationConstipationPainPainNeutropenic FeverNeutropenic FeverHair LossHair Loss

Monitoring

How often is monitoring needed?
Labs (blood tests) may be checked before treatment, up to weekly during treatment, before each new cycle, and at the end of treatment. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), and checking the prostate specific antigen (PSA) level to monitor response to therapy, plus any others your doctor may order.

How often is imaging needed?
Imaging may be checked before treatment, during treatment, and after treatment is completed. Imaging may include: CT scan, bone scan, or other imaging your doctor may order.

How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue cabazitaxel as planned, decrease the dose, or delay or switch therapy.

ChemoExperts Tips

  • Cabazitaxel, like other taxane chemotherapy medications, can cause infusion reactions. You will receive premedications including an antihistamine (ex. Diphenhydramine), corticosteroid (ex. Dexamethasone), and histamine H2-antagonist (ex. Ranitidine) before each infusion
  • Because of the risk of neutropenic fever with cabazitaxel, your doctor may prescribe a white blood cell growth factor to be given after your chemotherapy. Make sure to tell your health care team if you have any signs or symptoms of infection during treatment with cabazitaxel
  • Cabazitaxel may interact with other medications (ex. certain antifungal medications) and may require a dose reduction. Therefore, a pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
  • Clinical trials may exist for prostate cancer. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications

Patient Assistance & Co-payment Coverage

Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Cabazitaxel (Jevtana®) + Prednisone, we have provided links that may help.

Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Cabazitaxel (Jevtana®) + Prednisone. Depending upon your income, they may be able to help cover the cost of:

  • Cabazitaxel
  • Pred­nisone

For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.

  • If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.

Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Cabazitaxel (Jevtana®) + Prednisone and are the best source to help you understand drug cost.

  • Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.

Emotional Wellness

What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.

Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.

Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.

Learn more about pursuing emotional wellness while receiving treatment with Cabazitaxel (Jevtana®) + Prednisone

Individual Drug Label Information

Cabazitaxel (Jevtana)

  • Cabazitaxel is an intravenous (I.V.) infusion that is typically given over one hour 
  • Neutropenic deaths have been reported with this medication. Frequent blood counts (such as a CBC) should be obtained for all patients receiving cabazitaxel
  • Severe hypersensitivity reactions, such as rash, low blood pressure, and trouble breathing, can occur. 
  • Kidney problems can occur and should be managed aggressivley
  • Patients should receive premedications before each dose, such as diphenhydramine, dexamethasone, AND ranitidine or famotidine
  • Use is not recommended in patients with a history of severe reaction to cabazitaxel or other drugs dissolved in "polysorbate 80."
  • Dosage adjustments may be required for any degree of liver impairment, low blood counts, gastrointestinal toxicity (ex. severe diarrhea), or severe peripheral neuropathy 
  • May interact with certain anti-fungal medications or HIV medications and dose reduction of cabazitaxel may be required 
  • Cabizitaxel is NOT indicated for the treatment of female patients
  • Can cause fetal harm. It is not indicated for use in female patients 
General Cabazitaxel (Jevtana) Side Effects 
  • Low blood cell counts (neutrophils-which help fight infection, red cells-which carry oxygen, platelets-which prevent bleeding)
  • Diarrhea 
  • Fatigue 
  • Nausea 
  • Vomiting 
  • Constipation
  • Weakness
  • Abdominal pain
  • Blood in urine
  • Decreased appetite
  • Back pain
  • Nerve pain 
  • Joint pain
  • Fever
  • Swelling or pain in arms or legs
  • Shortness of breath
  • Altered taste
  • Cough
  • Hair loss
  • Some side effects were observed more frequently in patients over 65 years of age (compared to younger patients). These include neutropenia, fatigue, pyrexia (fever), dizziness, urinary tract infection, and dehydration. 
  • Click on the cabazitaxel (Jevtana) package insert below for reported side effects and possible drug interactions

Side Effect Videos
Nausea and VomitingNausea and VomitingDiarrheaDiarrheaFatigue Fatigue ConstipationConstipationPainPainAnemiaAnemiaNeutropenic FeverNeutropenic Fever

See DailyMed package insert.

Pred­nisone (Deltasone®)

  • Prednisone is an oral medication, usually supplied as a white tablet
  • Prednisone may increase the risk of infection. Depending upon how much prednisone is taken, antibiotics may be prescribed to help prevent infections during treatment with prednisone
  • Should be taken with food and with a large glass of water to avoid stomach irritation or ulcers
  • Should be taken before 6 P.M. when possible, to avoid trouble falling asleep
  • May decrease the response to vaccines; vaccines may need to be repeated at a later date to obtain maximal response
  • If taken daily for several days or weeks, the dose of prednisone may need to be gradually decreased to avoid withdrawal symptoms
  • If you miss a dose, take the next dose as soon as possible
  • Should be stored at room temperature
General Prednisone Side Effects
  • May cause high blood sugar, weight gain, irritability, high blood pressure, difficulty sleeping, stomach ulcers, bone loss, muscle weakness
  • Click on the Prednisone package insert below for reported side effects and potential drug Interactions
See DailyMed package insert.

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References

1) de Bono JS, Oudard S, Ozguroglu M, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet. 2010;376:1147-1154.

2) Bahl A, Oudard S, Tombal B, et al. Impact of cabazitaxel on 2-year survival and palliation of tumour-related pain in men with metastatic castration-resistant prostate cancer treated in the TROPIC trial. Ann Oncol. 2013;24:2402-2408.

Created: April 29, 2016 Updated: October 3, 2018

What is Prostate Cancer?

A disease of the cells found in the prostate gland in men.  Prostate cancer is a common condition caused by abnormal growth and rate changes in the prostate gland cells that form tumors.  The stage of prostate cancer can vary at diagnosis and throughout treatment.  The staging includes both the TNM + Grade, which is based on exam of tissue removed by surgery, and clinical staging: Stage I, IIa, IIb, III, IV.  The effectiveness of the treatment may depend upon the stage at diagnosis.

NOTE: Treatment Options listed below are not all-inclusive. Other treatments may be available. ChemoExperts provides drug information and does not recommend any one treatment over another. Only your Doctor can choose which therapy is appropriate for you.

What does "Cure" mean?

The word “cure” means there are no cancer cells left in the body and cancer will never come back. Depending on the cancer type and stage, this may be the true goal of therapy. However, it is very difficult to prove all cancer cells are gone. Even though images, like X-rays and MRI’s, and blood tests may not show any signs of cancer, there can be a small amount of cancer cells still left in the body. Because of this, doctors use the word “remission” is used more often. This means there are no signs or symptoms of cancer. Patients in remission are followed closely for any signs of cancer returning. Sometimes, more chemotherapy may be given while in remission to prevent the cancer from coming back.

Doctors usually do not consider a patient “cured” until the chance of cancer returning is extremely low. If cancer does return, it usually happens within 5 years of having a remission. Because of this, doctors do not consider a patient cured unless the cancer has not come back within 5 years of remission. The five-year cutoff does not apply to all cancers.

Common Starting Doses

  • Cabazitaxel 25 or 20 mg/m2 intravenous infusion over 1 hour on Day One
  • Prednisone 10 mg by mouth once daily continuously

Note: Individual doses may vary based upon your Doctor's recommendation, or drug availability

Clinical Studies

If you are interested in reading the clinical trials results, please click on references below: 

1) de Bono JS, Oudard S, Ozguroglu M, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet. 2010;376:1147-1154.

2) Bahl A, Oudard S, Tombal B, et al. Impact of cabazitaxel on 2-year survival and palliation of tumour-related pain in men with metastatic castration-resistant prostate cancer treated in the TROPIC trial. Ann Oncol. 2013;24:2402-2408.

What is a CBC?

A Complete Blood Count (CBC) is a frequently ordered blood test that tells clinicians the status of your: 1) White blood cell count, 2) Hemoglobin, and 3) Platelet count at the time the test was taken.

Common uses:
1) White blood cell count (WBC): is used to determine infection risk, or response to chemotherapy. Certain chemotherapy agents may harm our good infection-fighting cells. Sometimes chemotherapy may need to be delayed to allow these cells to recover.

2) Hemoglobin: is used to determine if someone is anemic. Anytime the hemoglobin is below 12 g/dL, the person is said to be anemic. Red blood cell transfusions, and sometimes iron can be given to restore the hemoglobin level, but anemia treatment should always aim at treating the underlying cause or condition.

3) Platelet count: is used to determine if the risk of bleeding is increased or if a platelet transfusion is required to prevent bleeding. Certain medications that increase bleeding risk, such as: aspirin, certain chemotherapy agents, and blood thinners, may need to be stopped temporarily until the platelet count is within a safe range.

What is a CMP?

A Comprehensive Metabolic Panel (CMP) is a frequently ordered blood test that tells clinicians the status of your: 1) Electrolytes & Acid/Base status2) Kidney function, 3) Liver function, 4) Blood sugar, and 5) Calcium at the time the test was taken. It is commonly used to monitor liver and kidney function when beginning new medications such as chemotherapy. A total of 14 tests are run simultaneously and are shown below.

Electrolytes & Acid/Base status:
1) Sodium, 2) Potassium, 3) Carbon dioxide, 4) Chloride

Kidney Function:
5) BUN (blood urea nitrogen), 6) Serum creatinine (Scr)

Liver Function:
7) AST, 8) ALT, 9) Total bilirubin, 10) Alk Phos, 11) Albumin, 12) Total protein

Blood sugar:
13) Serum glucose

Calcium:
14) Serum calcium