cabazitaxel

Assessment

• Assess for hypersensitivity reactions (generalized rash/erythema, hypotension, bronchospasm, swelling of face). May occur within minutes following initiation of infusion. If severe reactions occur, discontinue infusion immediately and provide supportive therapy.

• Assess for nausea, vomiting, and severe diarrhea; may result in death due to electrolyte imbalance. Premedication is recommended. Treat with rehydration, anti-diarrheal, or antiemetic therapy as needed. If Grade ≥3 diarrhea or persisting diarrhea occurs despite appropriate medication, fluid and electrolyte replacement, delay treatment until improvement or resolution, then reduce dose to 20 mg/mL.

• Monitor CBC weekly during cycle 1 and before each treatment cycle thereafter. Do not administer if neutrophils ≤1500/mm³. If prolonged grade 3 neutropenia (>1 wk) despite appropriate medication including filgrastim, delay treatment until neutrophil count is >1500 mm³, then reduce dose to 20 mg/m². Use filgrastim for secondary prophylaxis.

» If febrile neutropenia occurs, delay therapy until improvement or resolution and neutrophil count is >1500/mm³, then reduce dose to 20 mg/m². Use filgrastim for secondary prophylaxis.

» Discontinue cabazitaxel if prolonged Grade 3 neutropenia, febrile neutropenia or Grade 3 diarrhea occur at the 20 mg/m² dose.

» May cause hematuria.

» May cause Grade 3–4 ↑ AST, ↑ ALT, and ↑ bilirubin.