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Updated: Aug 7, 2026
A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
Transient PSA Suppression Without Survival Benefit: Real-World Comparative Effectiveness of Cabazitaxel Plus
Ahmad Basharat1, Muhammad Shaheer Mannan1, Muhammad Raffey Shabbir1
1Department of Internal Medicine, Marshfield Clinic Health System, Marshfield, WI.
Background:
Platinum-based intensification has emerged as a potential strategy in metastatic castration-resistant prostate cancer (mCRPC). However, its real-world effectiveness remains uncertain.
Methods:
We conducted a retrospective cohort study using the TriNetX Research Network. Adult with mCRPC treated with cabazitaxel with or without carboplatin were identified. Propensity score matching (1:1) was performed using demographic, clinical, and laboratory variables. Primary outcomes included overall survival (OS) and prostate- specific antigen (PSA) suppression, defined as PSA response (<4 ng/mL), intermediate (4-20 ng/mL), and high (>20 ng/mL) assessed at 6 months and 1 year. Secondary outcomes included treatment-related toxicities and healthcare utilization.
Results:
After matching, 1,618 patients were included (809 per cohort). Baseline PSA was comparable between groups (median 22.5 vs 21.9 ng/mL). At 6 months, combination therapy achieved significantly greater PSA response (<4 ng/mL: 13.2% vs 9.0%; RR 1.47; 95% CI, 1.11-1.94; p=0.007). By 1 year, this difference was no longer significant (14.8% vs 14.2%; p=0.68). No OS difference was observed (median OS 319 vs 280 days; HR 0.97; p>0.5). Hematologic toxicities were more frequent with combination therapy.
Conclusions:
In this large, biomarker unselected real-world cohort, carboplatin added to cabazitaxel produced significantly greater PSA response at 6 months, resolving by 1 year, and was not accompanied by an OS benefit. Given the higher hematologic toxicity, these results support a selective rather than routine role for platinum intensification in mCRPC.
