Dr. de Wit on Rationale for Phase III CARD Trial in Metastatic CRPC

Ronald de Wit, MD, PhD, group leader, Experimental Systematic Therapy of Urogenital Cancers program, Erasmus MC Cancer Institute, Rotterdam, Netherlands, discusses the rationale for the randomized phase III CARD trial which showed a significant overall survival (OS) benefit with third-line cabazitaxel (Jevtana) in patients with metastatic castration-resistant prostate cancer (mCRPC).

Docetaxel and the androgen signaling inhibitors, abiraterone acetate (Zytiga) and enzalutamide (Xtandi) are frequently used in the metastatic castration-resistant setting. However, once patients progress on one of the androgen signaling inhibitors, they are not likely to respond to the other agent, de Wit explains. Cabazitaxel, though available, is often used as the last intervention.

As such, patients in the CARD trial were randomized to receive either cabazitaxel or abiraterone or enzalutamide, depending on which androgen signaling inhibitor they had received previously.

After a median follow-up of 9.2 months, investigators reported a median OS of 13.6 months with cabazitaxel versus 11.0 months with either abiraterone or enzalutamide (HR 0.64; 95% CI 0.46—0.89; P =.008).