1 Recommendations

1 Recommendations

1.1 Cabazitaxel in combination with prednisone or prednisolone is recommended as an option for treating metastatic hormone‑relapsed prostate cancer in people whose disease has progressed during or after docetaxel chemotherapy, only if:

  • the person has an eastern cooperative oncology group (ECOG) performance status of 0 or 1

  • the person has had 225 mg/m2 or more of docetaxel

  • treatment with cabazitaxel is stopped when the disease progresses or after a maximum of 10 cycles (whichever happens first).

    In addition, cabazitaxel is recommended only if:

  • the company provides cabazitaxel with the discount in the patient access scheme agreed with the Department of Health, and

  • NHS trusts purchase cabazitaxel in accordance with the commercial access agreement between the company and NHS England, either:

    • in pre‑prepared intravenous infusion bags, or

    • in vials, at a reduced price that includes a further discount reflecting the average cost of waste per patient (see section 2.3 for details).

1.2 When using ECOG performance status, healthcare professionals should take into account any physical, sensory or learning disabilities, or communication difficulties that could affect ECOG performance status and make any adjustments they consider appropriate.

1.3 This guidance is not intended to affect the position of patients whose treatment with cabazitaxel was started within the NHS before this guidance was published and whose treatment with cabazitaxel is not recommended in this NICE guidance. Treatment of those patients may continue without change to whatever funding arrangements were in place for them before this guidance was published until they and their NHS clinician consider it appropriate to stop.

  • National Institute for Health and Care Excellence (NICE)