SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Pharmacology of Anti-Cancer Drugs
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1586650
This article is part of the Research TopicEvidence-Based Research and Clinical Application of Adverse Reactions and Management Strategies for Cancer Treatment DrugsView all 9 articles
The efficacy and safety of cabazitaxel in the treatment of metastatic castration-resistant prostate cancer: a systematic review and network meta-analysis based on randomized controlled trials
Provisionally accepted
- 1Henan Polytechnic University, Jiaozuo, Henan Province, China
- 2Xizang Minzu University, Xianyang, Shaanxi Province, China
- 3The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- 4China Tibetology Research Center Beijing Hospital of Tibetan Medicine, Beijing, China
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Background: Cabazitaxel (CAB) has been approved for the treatment of patients with progressed metastatic castration-resistant prostate cancer (mCRPC) after receiving docetaxel. To assess the efficacy and safety of CAB in mCRPC patients through systematic review and network meta-analysis.Methods: Randomized controlled studies on the treatment of mCRPC with CAB in PUBMED, EMBASE, Cochrane, and Web of Science were searched. Relevant studies that met pre-set criteria were determined, and the quality of included studies was evaluated using the National Institutes of Health-Quality Assessment Tool. After the data was extracted, data analysis was conducted in R 4.3.2. Overall survival (OS), progression-free survival (PFS), and serious adverse events (SAEs) were used as the primary outcomes, and HR (hazard ratio) or RR (risk ratio) and their 95% confidence intervals (95% CrI) were calculated as effect sizes.Results: A total of 13 studies were included, involving 5,814 patients. The overall risk of bias for 13 studies was low. The results showed that CAB 25 mg/m² significantly improved OS compared to androgen receptor pathway inhibitor (ARPI) (1.50 [1.30, 1.70]) and MIT (1.40 [1.20, 1.70]), but its efficacy was inferior to Lu-PSMA (0.42 [0.27, 0.67]) and therapeutic drug monitoring (TDM)-CAB (0.51 [0.38, 0.70]). CAB 25 mg/m² could significantly improve PFS compared to CAB+CP (1.40 [1.10, 2.00]), ARPI (1.80 [1.50, 2.30], MIT (1.40 [1.20, 1.60]), but its efficacy was not as good as CAB 20 mg/m² (0.92 [0.82, 1.00]), Lu-PSMA (0.58 [0.41, 0.80]), TDM-CAB (0.67 [0.51, 0.86]). In addition, compared to CAB 25 mg/m², CAB+CP may significantly increase the risk of SAEs (3.10 [1.70, 5.90]).Conclusion: CAB is an effective treatment in mCRPC, and combining it with other treatment methods may enhance efficacy, but attention should be paid to the occurrence of adverse events.
Keywords: prostate cancer, castration resistance, Cabazitaxel, Meta-analysis, Systematic review
Received: 16 Apr 2025; Accepted: 07 Jul 2025.
Copyright: © 2025 Shao, Wan, Guo and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Cong Shao, Henan Polytechnic University, Jiaozuo, Henan Province, China
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