Drug reference
Treatment of hormone refractory metastatic prostate cancer in patients who have previously been treated with a docetaxel-containing regimen (in combination with prednisone or prednisolone) ▶BY INTRAVENOUS INFUSION ▶Adult: (consult product literature or local protocols)
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Avoid in Acute porphyrias p. 1120
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NICE decisions ▶Cabazitaxel for hormone-relapsed metastatic prostate cancer treated with docetaxel (updated August 2016) NICE TA391 Cabazitaxel (Jevtana ®) in combination with prednisone or prednisolone is recommended as an option for treating metastatic hormone-relapsed prostate cancer in patients whose disease has progressed during or after docetaxel chemotherapy, only if the following criteria are met: . the patient has an eastern cooperative oncology group (ECOG) performance status of 0 or 1 . the patient has had 225 mg/m2 or more of docetaxel . treatment with cabazitaxel is stopped when the disease progresses or after a maximum of 10 cycles . the manufacturer provides cabazitaxel with the discount agreed in the patient access scheme . NHS trusts purchase cabazitaxel in accordance with the commercial access agreement, either in vials (at a reduced price to reflect the average cost of waste per patient), or in pre-prepared intravenous infusion bags. Patients currently receiving cabazitaxel that is not recommended according to the above criteria should have the option to continue treatment until they and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta391 Scottish Medicines Consortium (SMC) decisions SMC No. 735/11 The Scottish Medicines Consortium has advised (December 2016) that cabazitaxel (Jevtana ®) in combination with prednisone or prednisolone is accepted for restricted use within NHS Scotland for the treatment of patients with hormone refractory metastatic prostate cancer previously treated with a docetaxel-containing regimen (patients who have received at least 225 mg/m2 (three cycles) of docetaxel and have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1).This advice is contingent upon the continuing availability of the patient access scheme in NHS Scotland or a list price that is equivalent or lower.
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→Appendix 1: taxanes
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▶Common or very common Acute kidney injury. alopecia. anaemia. anxiety. appetite decreased. arrhythmias. arthralgia. asthenia. chest pain. chills. confusion. conjunctivitis. constipation. cough. cystitis. deep vein thrombosis. dehydration. diarrhoea. dizziness. dry mouth. dyspnoea. excessive tearing. fever. gastrointestinal discomfort. gastrointestinal disorders. haemorrhage. headache. hydronephrosis. hyperglycaemia . hypersensitivity. hypertension. hypokalaemia. hypotension. increased risk of infection. lethargy. leucopenia. malaise. mucositis. muscle complaints. nausea. nerve disorders. neutropenia. oedema. oropharyngeal pain. pain. pelvic pain. renal colic. renal failure (fatal cases of renal failure reported). sensation abnormal. sepsis. skin reactions. taste altered. thrombocytopenia. tinnitus. ureteral obstruction. urinary disorders. vasodilation. vertigo. vomiting. weight decreased ▶Frequency not known Respiratory disorders
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Ensure effective contraception during treatment (women) and for up to 6 months after treatment (men).
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See also Pregnancy and reproductive function in Cytotoxic drugs p. 938.
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Discontinue breast-feeding.
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Manufacturer advises caution in mild to moderate impairment; avoid in severe impairment. Dose adjustments Manufacturer advises dose reduction in mild to moderate impairment—consult product literature.
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Use with caution if creatinine clearance less than 50 mL/minute.
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Monitor electrolytes— correct dehydration.
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Intravenous infusion incompatible with PVC.
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There can be variation in the licensing of different medicines containing the same drug. Solution for infusion EXCIPIENTS: May contain Ethanol ▶Jevtana (Sanofi) Cabazitaxel 40 mg per 1 ml JEVTANA 60mg/1.5ml concentrate and solvent for solution for infusion vials | 1 vial P £3,696.00 (Hospital only)
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(consult product literature or local protocols)
First-line fragment. Read the complete Indications and Dose section above.
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