Cabazitaxel, also known as Jevtana®, is a chemotherapy drug that's used to treat advanced prostate cancer when the cancer can no longer be controlled by hormonal therapy. Cabazitaxel is given to people after they've been treated with the chemotherapy drug docetaxel.
What cabazitaxel looks like
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Cabazitaxel is a clear, slightly yellow fluid.
Cabazitaxel can be given as a drip (intravenous infusion) using a cannula, central line or PICC line. A cannula is a thin, flexible tube that the nurse puts into a vein in your hand or arm. You may find this uncomfortable or a little painful, but it shouldn't take long. The cannula is used to give the treatment, and is removed afterwards.
Some people have their chemotherapy given through a central line, which is a thin, plastic tube inserted under the skin and into a vein near the collarbone. Other people have it through a PICC line, which is a thin, plastic tube passed through a vein in the crook of the arm. Central lines and PICC lines are usually inserted under a local anaesthetic; a general anaesthetic is sometimes used.
If you're having your treatment as an outpatient you can then go home. If you have a cannula, it will be removed before you go. If you have a central or PICC line, it will usually stay in place ready for the next cycle of your chemotherapy. You'll be shown how to look after the line at home.
While on cabazitaxel, you'll also be given the steroid prednisolone. Prednisolone is taken as tablets daily throughout your treatment.
Your nurse or doctor will discuss your treatment plan with you. Before you begin your treatment your doctor will arrange for you to have blood tests. You will usually be given anti-sickness (anti-emetic) drugs before and/or during your treatment.
Chemotherapy is usually given as a course of several sessions (cycles) of treatment over a few months. Cabazitaxel is usually given to you as an outpatient every three weeks. The infusion takes about 60 minutes.
Each person’s reaction to chemotherapy is different. Some people have very few side effects while others may experience more. The side effects described here won't affect everyone who is given cabazitaxel.
We have outlined the most common side effects, but haven't included those that are rare and unlikely to affect you. If you notice any effects that are not listed here, discuss them with your doctor, chemotherapy nurse or pharmacist.
Risk of infection
Cabazitaxel can reduce the number of white blood cells, which help to fight infection. White blood cells are made by the bone marrow. If the number of your white blood cells is low, you are more likely to get infections. A low white blood cell count is called neutropenia.
This begins about seven days after treatment and your resistance to infection is usually at its lowest 10–14 days after chemotherapy. The number of your white blood cells will then increase steadily and usually return to normal before your next cycle of chemotherapy is due.
Contact your doctor or the hospital straight away if:
your temperature goes above 38°C (100.4°F)
you suddenly feel unwell, even with a normal temperature.
You'll have a blood test before having more chemotherapy to check the number of white blood cells. Occasionally, your treatment may need to be delayed if the number of your blood cells (blood count) is still low.
Cabazitaxel can reduce the number of red blood cells, which carry oxygen around the body. A low red blood cell count is called anaemia. This may make you feel tired and breathless. Tell your doctor or nurse if you have these symptoms. You may need to have a blood transfusion if the number of red blood cells becomes too low.
Bruising and bleeding
Cabazitaxel can reduce the production of platelets, which help the blood to clot. Tell your doctor if you have any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin. You can have a platelet transfusion if your platelet count is low.
Some people can have an allergic reaction to cabazitaxel while it’s being given. Signs of this can include skin rashes or redness of the skin, low blood pressure and breathing difficulties.
It‘s most common with the first or second infusion. You’ll also be given medicines before the treatment to help prevent or reduce any reaction. You’ll be monitored closely during your infusion but it's important to tell your nurse or doctor if you feel unwell or have any of the above symptoms. If you do have a reaction, it can be treated quickly.
Cabazitaxel can cause diarrhoea. This may be quite severe, but can usually be controlled with medicines. It is important to drink plenty of fluids, and you may be given medicine to take. Follow the instructions and take it immediately. If you have diarrhoea more than 4-6 times a day, or if you have it at night, contact your specialist for advice immediately. Your treatment with cabazitaxel may be delayed. However, once the diarrhoea has eased, your doctor will tell you if you can restart the treatment, perhaps at a lower dose.
Feeling tired is a common side effect of chemotherapy especially towards the end of treatment and for some weeks after it’s over. It’s important to try to pace yourself and get as much rest as you need. Try to balance this with taking some gentle exercise, such as short walks, which will help. If tiredness is making you feel sleepy, don’t drive or operate machinery.
You may feel very weak when having cabazitaxel chemotherapy. This may affect all or parts of your body. Tell your doctor if this is a problem.
Feeling sick (nausea) or being sick (vomiting)
Your doctor can prescribe very effective anti-sickness drugs to prevent, or greatly reduce, nausea or vomiting. If the sickness isn't controlled, or if it continues, tell your doctor and they can prescribe other anti-sickness drugs that may be more effective. It is important to try to take in fluids if you have been sick to prevent you from becoming dehydrated.
Some anti-sickness drugs can cause constipation. Let your doctor or nurse know if this is a problem.
You may get constipated. This can usually be helped by drinking plenty of fluids, eating more fibre in your diet and doing some gentle exercise. You may need to take medicine (laxatives) to help. Your doctor can prescribe these or you can buy them at a pharmacy.
Loss of appetite
Some people lose their appetite while they’re being treated with cabazitaxel. This can be mild and may only last a few days. If it doesn’t improve, you can ask to see a dietitian or specialist nurse at your hospital. They can give you advice on improving your appetite and keeping to a healthy weight.
Let your doctor know if you develop any pain in your tummy (abdomen). It can usually be controlled with mild painkillers.
Numbness or tingling in the hands or feet
This is due to the effect of cabazitaxel on nerves and is known as peripheral neuropathy. You may also notice that you have difficulty doing up buttons or similar fiddly tasks.
Tell your doctor if you notice any numbness or tingling in your hands or feet. It’s important to report your symptoms to your doctor, as they may be controlled by either delaying your treatment or slightly lowering the dose of the drug.
This side effect usually improves slowly, a few months after the treatment has finished. Sometimes symptoms can persist; talk to your doctor if this happens.
Blood in the urine (Haematuria)
When you have advanced prostate cancer, it is common for some people to have blood in their urine. This may increase when you are given cabazitaxel. Contact your doctor if you notice increased blood in your urine after being treated with cabazitaxel.
Cabazitaxel can affect your kidneys. You will have tests to check how well your kidneys are working before you have your treatment. Your doctors will take regular blood tests to check your kidneys during treatment.
It’s important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they’re not mentioned in this fact sheet.
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Pain along the vein
Cabazitaxel can cause pain along the vein that is used to give you chemotherapy. If you feel any pain, tell your doctor or nurse straight away so that they can check the infusion site. They may slow the infusion down to reduce pain.
Blood clot risk
Cancer can increase the risk of developing a blood clot (thrombosis), and chemotherapy may increase this risk further.
A blood clot may cause symptoms such as pain, redness and swelling in a leg, or breathlessness and chest pain. Blood clots can be very serious, so it’s important to tell your doctor straight away if you notice any of these symptoms. Most clots can be treated with drugs that thin the blood. Your doctor or nurse can give you more information.
Some medicines, including those you can buy in a shop or chemist, can be harmful to take when you’re having chemotherapy. Tell your doctor about any medicines you're taking (especially any medicine used for infections and seizures), including over-the-counter drugs, complementary therapies and herbal drugs. Avoid taking St John’s Wort, eating grapefruit or drinking grapefruit juice while you're having cabazitaxel.
Your ability to father a child may be affected by having this treatment. It’s important to discuss fertility with your doctor before starting treatment.
It's not advisable to father a child while having cabazitaxel, as it may harm the developing baby. It’s important to use effective contraception during and for up to six months after treatment. You can discuss this with your doctor.
It’s not known whether chemotherapy drugs can be present in semen or vaginal fluids. To protect your partner, it’s safest to either avoid sex or use a barrier form of contraception for about 48 hours after chemotherapy.
If you’re admitted to hospital for a reason not related to the cancer, it’s important to tell the doctors and nurses looking after you that you’re having chemotherapy treatment. You should tell them the name of your cancer specialist so that they can ask for advice.
It’s a good idea to know who you should contact if you have any problems or troublesome side effects when you’re at home. During office hours you can contact the clinic or ward where you had your treatment. Your chemotherapy nurse or doctor will tell you who to contact during the evening or at weekends.
This section is based on our Capecitabine factsheet, which has been compiled using information from a number of reliable sources, including:
Kavita Kantilal, Oncology Pharmacist; Dr Lisa Pickering, Consultant Medical Oncologist; and the people affected by cancer who reviewed this edition.
British National Formulary. 62nd edition. 2011. British Medical Association and Royal Pharmaceutical Society of Great Britain.
De Bono JS, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration resistant prostate cancer progressing after docetaxel treatment: a randomised open label trial. The Lancet. 2010. 376: 1147–1154.
electronic Medicines Compendium (accessed June 2012).
European Medicines Agency. www.ema.europa.eu/ema/index. (accessed June 2012).
National Institute for Health and Clinical Excellence. (accessed June 2012).
www.uptodate.com ( accessed June 2012).