The active medical ingredient cabazitaxel is half synthetically obtained and belongs to the so-called cytostatics. As such, cabazitaxel is used in the treatment of an already advanced prostate cancer. An indication exists primarily for forms of cancer that cannot be eliminated by castration. Cabazitaxel achieves its efficacy by inhibiting the cell division phase of cancer cells.
What is cabazitaxel?
Cabazitaxel is an important cytostatic drug. This term is used to describe various substances that can be used as part of a comprehensive chemotherapy regimen to treat various forms of cancer. The area of application of cabazitaxel represents various forms of prostate cancer. Here, the active ingredient is mainly used as a second-line drug. This means that cabazitaxel is primarily used as an additional line of therapy alongside other drugs. The substance is obtained semisynthetically and described in chemistry and pharmacology by the molecular formula C 45 – H 57 – N – O 14, which corresponds to a moral mass of approximately 853.93 g/mol. Cabazitaxel exists as a white solid at room temperature and is used, among others, in the preparation Jevtana. It has a marketing authorization for the European Union (EU). However, cabazitaxel is subject to prescription and pharmacy requirements in each member state. Since it is a chemotherapy, it is administered exclusively as an infusion solution under medical supervision. Independent administration by the patient is thus excluded.
Pharmacologic effects on the body and organs
Cabazitaxel is produced semisynthetically from the natural product 10-deacetylbaccatin III, which is obtained by extraction from egg needles. Cabazitaxel achieves its efficacy by inhibiting the cell division phase. This makes it impossible for cancer cells to form spindle apparatuses. The effects of cabazitaxel are therefore considered cytotoxic. Because of the way its mechanism of action works, cabazitaxel can also be called a mitosis inhibitor.
Medical use and use for treatment and prevention.
One indication of cabazitaxel, together with the agents prednisolone or prednisone, is for the therapy of adults who have hormone-refractory metastatic carcinoma of the prostate and have already been treated with a docetaxel-based therapeutic regimen. Accordingly, the main indication for cabazitaxel is the treatment of castration-resistant prostate cancer that has been previously treated with chemotherapy. Consequently, cabazitaxel is a second-line drug. It is therefore only the second pillar in addition to therapy with other agents (so-called second-line therapy). Cabazitaxel is sold exclusively as a concentrate together with a corresponding solvent. Medical professionals prepare an infusion solution from the concentrate and the solvent. This clear, yellow or brownish-yellow infusion solution is described as oily and is administered intravenously to the patient. This procedure is typical for chemotherapy, as it ensures that the solution is taken under the supervision of qualified personnel. Independent intake by the patient (e.g. orally in the form of film-coated tablets) does not take place. The dosage is administered every three weeks. The respective dosage is set at 25 mg/m2 KOF. The duration of the infusion is usually one hour, although other agents such as prednisone or prednisolone are often administered with it, in addition to cabazitaxel. A prerequisite of the use of cabazitaxel is that the patient have at least 1500 neutrophil granulocytes per cubic millimeter in the blood.
Risks and Side Effects
Cabazitaxel, like all other cytostatic drugs used to treat cancer, can cause side effects, some of which are severe. These include prolonged neutropenia, i.e., lasting more than one week, febrile neutropenia, or severe diarrhea. Diarrhea can be treated with electrolyte and fluid replacement, but treatment should be temporarily suspended and the dose reduced. Other side effects of cabazitaxel include fever, general weakness, general malaise, severe and prolonged fatigue, back pain, and abdominal pain.Because cabazitaxel is metabolized (metabolized) primarily by the liver, there is a contraindication for patients with severe liver damage. They must not take cabazitaxel. People suffering from mild or moderate liver dysfunction must inform their doctor. The dosage should be reduced accordingly or another agent should be used. Cabazitaxel may interact with other medications. This may be particularly the case when taking CYP3A inhibitors such as ketoconazole, OATP1B1 or CYP3A inducers such as rifampicin. Symptoms of fatigue may occur after taking cabazitaxel. Therefore, heavy machinery must not be operated. Participation in road traffic is also restricted. In addition, cabazitaxel must not be administered if there is a known intolerance.
