Jevtana (Cabazitaxel) in the Treatment of Prostate Cancer
What is Jevtana?
Jevtana (Cabazitaxel) the powerful chemotherapeutic option for treatment of metastatic prostate cancer which has been shown to have good effectiveness. Jevtana is associated with a number of significant side effects and risks. At this time Jevtana is an option for men when less toxic treatments such as Xtandi and Zytiga do not work.
Cabazitaxel Jevtana (injectable) – a novel taxane that overcomes resistance to docetaxel
- JEVTANA® 25 mg/m2 as a 1-hour IV infusion every 3 weeks+ oral predisone 10 mg daily throughout treatment. Must premedicate patients before with steroids, antihistamine, antiemetic.
- 80% grade 3-4 neutropenia;
JEVTANA® is a microtubule inhibitor that:
- Approved for use in combination with prednisone for treatment of metastatic hormone-refractory prostate cancer previously treated with a docetaxel-containing regimen.
- Administer the following IV medications at least 30 minutes prior to each dose of JEVTANA®:
- Antihistamine (dexchlorpheniramine 5 mg, or diphenhydramine 25 mg or equivalent antihistamine)
- Corticosteroid (dexamethasone 8 mg or equivalent steroid)
- H2 antagonist (ranitidine 50 mg or equivalent H2 antagonist)
- Anti-emetic prophylaxis (oral and intravenous) is recommended as needed
Consider primary prophylaxis with G-CSF in patients with high-risk clinical features
Premedication Prior to Jevtana
- – lower therapeutic index (Ratio of lethal to therapeutic dose): neutropenia with fatal outcomes after one injection; renal failure; VFib, dyspnea, cerebral hemorrhage. Death within 30 days 5% of treated pts vs 1% of untreated patients.
Median survival was 15.1 months for patients treated with cabazitaxel and 12.7 months for patients treated with mitoxantrone
ClinicalTrials: Cabazitaxel: TCC after platinum-based chemo; combined with cisplatin post-docetaxel; post-docetaxel; use in combination with RT+hormones during RT