Cabazitaxel (Jevtana)

Cabazitaxel is a type of taxane chemotherapy drug. The taxanes were originally developed from the yew tree. Cabazitaxel is also called Jevtana. It works by stopping cancer cells dividing into 2 new cells and so blocks the growth of the cancer.

It is a treatment for advanced prostate cancer for men who have had hormone treatment and docetaxel chemotherapy treatments which are no longer working. While you are having cabazitaxel you also take steroid tablets (usually prednisone or prednisolone). Research is also looking at cabazitaxel as a treatment for other types of cancer.

You have cabazitaxel as a drip (infusion) into your bloodstream (intravenously). You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in just before your course of treatment starts and it stays in place as long as you need it.

You take the steroids as tablets.

You usually have chemotherapy as a course of several cycles of treatment. Each cycle of treatment lasts 3 weeks. You have the cabazitaxel once every 3 weeks and take the steroid tablets every day.

The side effects associated with cabazitaxel are listed below. You may have 1 or 2 or a few side effects. You can use the links to find out more about each effect. For general information, see our cancer drug side effects section.

More than 10 in every 100 people have one or more of the side effects listed below.

Temporary drop in the number of blood cells made by the bone marrow, causing

• Increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery
• Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
• Bruising more easily due to a drop in platelets – this can cause nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)

Some of these side effects can be life threatening, particularly infections. You should contact your doctor if you have any of these side effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

Other common side effects include

• Diarrhoea in just under half the people who have cabazitaxel
• Tiredness during and after treatment in about 4 out of 10 people
• Feeling weak – this occurs in 1 in 5 people
• Feeling or being sick in about 1 in 3 people (33%)
• Constipation in 1 in 5 people (20%)
• Shortness of breath in just over 1 in 10 people (10%)
• Blood in the urine (haematuria)
• Cabazitaxel may have a harmful effect on a baby developing in the womb. You should not father a child whilst taking this drug. Discuss contraception with your doctor before you start your treatment if there is any possibility that your partner could become pregnant

Between 1 and 10 in every 100 people have one or more of these.

• Urine infections – symptoms include passing urine frequently, pain when passing urine, and a raised temperature. If you have any of these contact your doctor
• A high temperature (fever)
• Loss of appetite
• Pain, including abdominal, joint, back and bone pain
• An allergic reaction during the infusion – this nearly always happens in the first 10 minutes. If you are going to have a reaction, it is most likely the first or second time you have the drug. Your chemotherapy nurse will monitor you closely for this. Let your treatment team know immediately if you feel hot or have any skin rashes, itching, dizziness, headaches, shivering, breathlessness, anxiety, flushing of the face, or a sudden need to pass urine

The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment, or more side effects may develop as the course goes on. This depends on

• How many times you've had the drug before
• Your general health
• The amount of the drug you have (the dose)
• Other drugs you are having

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your chemotherapy nurse will give you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies – some drugs can react together.

You should not have immunisations with live vaccines while you are having chemotherapy or for 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but not many people in the UK have oral vaccines now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK.

If you live abroad, you might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently.