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What Is Cabazitaxel (Jevtana<sup>®</sup>)?

Jevtana® (cabazitaxel) is a chemotherapy treatment option that has antineoplastic properties (meaning that it acts to prevent or halt the development and growth of tumors). It is indicated for use with prednisone in individuals with metastatic castration resistant prostate cancer (prostate cancer that has spread to other .parts of the body and is not responding to treatment to lower the body’s level of testosterone) who have previously been treated with a docetaxel treatment. Cabazitaxel is administered intravenously (IV injection into a vein) and is typically administered over a 1-hour period once every 3 weeks. Cabazitaxel is considered a second-line therapy. In some cases, cabazitaxel may be used with other hormone therapies. Individuals taking cabazitaxel should also be monitored for changes in blood cell counts, serious infections or allergic reactions, severe diarrhea, and changes in liver or kidney functioning.1

How does cabazitaxel work?

Cabazitaxel's active ingredient has antineoplastic properties, meaning that it acts to prevent tumor growth and development. Cabazitaxel does this by binding to the microtubules in a cell which play a key role in allowing cells to physically divide during the replication process. When a parent cell is unable to split into two daughter cells, it will eventually become too faulty and will die. When a cell manually kills itself because of a faulty cellular process it is called apoptosis. Chemotherapies cause cancer cells to stop dividing and undergo apoptosis, thus, slowing or halting the growth of a cancerous mass.

Cancerous cells are rapidly dividing while most other cells in our body aren’t, or are doing so at a slower rate. This property is what increases the chances of chemotherapies targeting cancer cells. However, there are still a few kinds of cells in our body that divide rapidly, such as hair cells or cells that line our intestines, which explains the common side effects of hair loss or gastrointestinal disruption while on certain chemotherapy medications. Blood cells, including important white blood cells, red blood cells, and platelets also divide on a regular basis, making it important to closely monitor someone on chemotherapy to make sure their blood cell counts aren’t dangerously low. If a person’s blood cell count dips below a certain threshold, they may be unable to receive chemotherapy until the issue has resolved.

Additionally, steroids like prednisone may be used with certain chemotherapies to increase their effectiveness when it comes to targeting and killing cancer cells as well as to prevent life-threatening swelling and other side effects.2

What are the possible side effects of cabazitaxel?

Multiple clinical trials evaluated the safety and efficacy of cabazitaxel. The most common side effects of cabazitaxel include feeling short of breath, decreased appetite, fatigue, changes in your sense of taste, constipation, nausea, vomiting, diarrhea, hair loss, and back pain. Many of these side effects, including hair loss, are generally reversible and will be remedied when the medication is stopped. Your provider will be able to determine what side effects may be longer-lasting in nature. This is not an exhaustive list of all potential side effects of cabazitaxel. Talk to your healthcare provider or pharmacist for further information.

Things to note about cabazitaxel

Several rare but more serious side effects can accompany cabazitaxel including neurological symptoms, serious gastrointestinal symptoms, and reproductive health complications. Alert your provider immediately if you notice any of the following symptoms:

  • Numbness, tingling, or burning of hands or feet
  • Muscle aches
  • Blood in your urine
  • Burning when urinating
  • Fever
  • Cough

Severe gastrointestinal symptoms such as extreme vomiting or diarrhea can deplete your body’s electrolytes and fluid supply. If these symptoms become too severe, they can deplete your body fluid and lead to death. This can also cause kidney failure if your body is under extreme dehydration. Alert your provider immediately if you have any of the following symptoms:

  • Severe diarrhea
  • Severe vomiting
  • Swelling of your face or body
  • A decrease in the amount of urine produced daily

Additionally, there is a risk of developing very low white and red blood cell and platelet counts while taking cabazitaxel. Your doctor will monitor you for any signs of this, however, it is important to self monitor for any signs of infection, shortness of breath, fatigue, unusual bruising, or bleeding. Individuals with a white blood cell count that is deemed to be too low to be able to handle the continuation of treatment will need to stop taking cabazitaxel until their blood cell count rises.

Cabazitaxel also has reproductive health risks. Male patients that have female partners who could become pregnant should use contraception during treatment and for 3 months after the last treatment as cabazitaxel can cause fetal harm (patients should discuss appropriate birth control methods with their doctor).

Before starting cabazitaxel talk to your provider if you:

  • Have any problems with your liver or kidneys
  • Are over the age of 65
  • Are allergic to cabazitaxel or any of its ingredients, or have any other allergies
  • Have a low white blood cell count, red blood cell count, or platelet count
  • Have any other medical conditions
  • Are currently taking any other medications (prescription and over-the-counter), vitamins, or herbal supplements

You should also contact your provider if you notice any signs of an allergic reaction to the medication, including chest pain or difficulty breathing. It is important to consult the prescribing information for any other medications taken with cabazitaxel, including prednisone.

Receiving cabazitaxel

Cabazitaxel is administered intravenously (IV), meaning through an injection into a vein. A typical injection of cabazitaxel takes about an hour to administer and is given once every 3 weeks. There is also a premedication regimen that contains an antihistamine, corticosteroid, and other medications that is typically provided intravenously 30 minutes prior to administering cabazitaxel that may help prevent any injection site or allergic reactions. Your provider will determine if this is necessary for you, as well as the appropriate dosage and administration schedule for you, including your length of treatment. They will also determine the appropriate dosage and administration schedule of any other medications taken with cabazitaxel, such as prednisone. Patients should talk to their doctor if they have any questions, or if they have questions regarding their cabazitaxel regimen.

It is important to follow your provided schedule exactly as instructed, and not to stop taking any accompanying medications on your own. The dose of your cabazitaxel can be adjusted as needed, and may need to be discontinued if your blood cell count is too low or if the side effects of treatment become too severe.1

These are not all the possible side effects of cabazitaxel. Patients should talk to their doctor about what to expect with treatment with cabazitaxel.

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Written by: Casey Hribar | Last reviewed: July 2020