Cabazitaxel

Identification

Summary

Cabazitaxel is an antineoplastic agent used for the treatment of hormone-refractory metastatic prostate cancer previously treated with a docetaxel-containing treatment regimen.

Brand Names
Jevtana
Generic Name
Cabazitaxel
DrugBank Accession Number
DB06772
Background

Cabazitaxel is an anti-neoplastic used with the steroid medicine prednisone. Cabazitaxel is used to treat people with prostate cancer that has progressed despite treatment with docetaxel. Cabazitaxel is prepared by semi-synthesis with a precursor extracted from yew needles (10-deacetylbaccatin III). It was approved by the U.S. Food and Drug Administration (FDA) on June 17, 2010.

Type
Small Molecule
Groups
Approved
Structure
Weight
Average: 835.9324
Monoisotopic: 835.377905537
Chemical Formula
C45H57NO14
Synonyms
  • Cabazitaxel
  • Cabazitaxelum
External IDs
  • RPR-116258A
  • RPR116258
  • TXD 258
  • TXD-258
  • TXD258
  • XRP 6258
  • XRP-6258
  • XRP6258

Pharmacology

Indication

For treatment of patients with hormone-refractory metastatic prostate cancer previously treated with a docetaxel-containing treatment regimen.

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Associated Conditions
Contraindications & Blackbox Warnings
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Pharmacodynamics

Cabaitaxel has anti-tumour properties and is effective against docetaxel-sensitive and -insensitive tumours.

Mechanism of action

Cabazitaxel is a microtubule inhibitor. Cabazitaxel binds to tubulin and promotes its assembly into microtubules while simultaneously inhibiting disassembly. This leads to the stabilization of microtubules, which results in the interference of mitotic and interphase cellular functions. The cell is then unable to progress further into the cell cycle, being stalled at metaphase, thus triggering apoptosis of the cancer cell.

TargetActionsOrganism
ATubulin alpha-4A chain
binder
Humans
ATubulin beta-1 chain
binder
Humans
Absorption

After an intravenous dose of cabazitaxel 25 mg/m2 every three weeks to a population of 170 patients with solid tumors, the mean Cmax in patients with metastatic prostate cancer was 226 ng/mL (CV 107%) and was reached at the end of the one-hour infusion (Tmax). The mean AUC in patients with metastatic prostate cancer was 991 ng.h/mL (CV 34%). Administration with prednisone or prednisolone do not effect the pharmacokinetic profile of cabazitaxel.

Volume of distribution

The volume of distribution (Vss) was 4,864 L (2,643 L/m2 for a patient with a median BSA of 1.84 m2) at steady state. Compared to other taxanes, penetrates the CNS to a greater extent.

Protein binding

Cabazitaxel is mainly bound to human serum albumin (82%) and lipoproteins (88% for HDL, 70% for LDL, and 56% for VLDL).

Metabolism

Cabazitaxel is extensively metabolized in the liver (>95%), mainly by the CYP3A4/5 isoenzyme (80% to 90%), and to a lesser extent by CYP2C8 which results in 20 different metabolites. Two of these metabolites are active demethylated derivatives of cabaxitaxel and referred to as RPR112698 and RPR123142 respectively. Docetaxel is another metabolite of cabazitaxel. Cabazitaxel is the main circulating moiety in human plasma.

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Route of elimination

After a one-hour intravenous infusion [14C]-cabazitaxel 25 mg/m2, approximately 80% of the administered dose was eliminated within 2 weeks. Cabazitaxel is mainly excreted in the feces as numerous metabolites (76% of the dose); while renal excretion of cabazitaxel and metabolites account for 3.7% of the dose (2.3% as unchanged drug in urine).

Half-life

Following a one-hour intravenous infusion, plasma concentrations of cabazitaxel can be described by a three-compartment pharmacokinetic model with α-, β-, and γ- half-lives of 4 minutes, 2 hours, and 95 hours, respectively.

Clearance

Cabazitaxel has a plasma clearance of 48.5 L/h (CV 39%; 26.4 L/h/m2 for a patient with a median BSA of 1.84 m2) in patients with metastatic prostate cancer.

Adverse Effects
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Toxicity

Cabazitaxel may cause serious side effects including neutropenia, hypersensitivity reactions, gastrointestinal symptoms, and renal failure. Anticipated complications of overdose include exacerbation of adverse reactions such as bone marrow suppression and gastrointestinal disorders. Cabazitaxel penetrates the blood-brain barrier. LD50, rat = 500 mg/kg

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbametapirThe serum concentration of Cabazitaxel can be increased when it is combined with Abametapir.
AbataceptThe metabolism of Cabazitaxel can be increased when combined with Abatacept.
AbciximabThe risk or severity of bleeding can be increased when Abciximab is combined with Cabazitaxel.
AbemaciclibCabazitaxel may decrease the excretion rate of Abemaciclib which could result in a higher serum level.
AbirateroneThe metabolism of Cabazitaxel can be decreased when combined with Abiraterone.
AbrocitinibThe serum concentration of Cabazitaxel can be increased when it is combined with Abrocitinib.
AcalabrutinibThe metabolism of Cabazitaxel can be decreased when combined with Acalabrutinib.
AcenocoumarolThe risk or severity of bleeding can be increased when Acenocoumarol is combined with Cabazitaxel.
AcetaminophenThe metabolism of Cabazitaxel can be increased when combined with Acetaminophen.
AcetazolamideThe serum concentration of Cabazitaxel can be increased when it is combined with Acetazolamide.
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Food Interactions
  • Avoid grapefruit products. Grapefruit inhibits the CYP3A4 metabolism of cabazitaxel, which may increase its serum concentration.
  • Avoid St. John's Wort. This herb induces the CYP3A4 metabolism of cabazitaxel and may reduce its serum concentration.

Products

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Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Cabazitaxel AccordInjection, solution, concentrate20 mg/mlIntravenousAccord Healthcare S.L.U.2020-12-23Not applicableEU flag
Cabazitaxel for InjectionSolution60 mg / 6 mLIntravenousSandoz Canada Incorporated2019-12-18Not applicableCanada flag
Cabazitaxel for InjectionKit; Solution40 mg / mLIntravenousMarcan Pharmaceuticals IncNot applicableNot applicableCanada flag
Cabazitaxel for InjectionSolution45 mg / 4.5 mLIntravenousSandoz Canada Incorporated2019-12-18Not applicableCanada flag
Cabazitaxel for InjectionSolution40 mg / mLIntravenousDr Reddy's Laboratories Ltd2020-06-01Not applicableCanada flag
JevtanaInjection, solution, concentrate60 mg/1.5mlIntravenousSANOFI WINTHROP INDUSTRIE2020-12-23Not applicableEU flag
JevtanaInjection60 mg/1.5mLIntravenoussanofi-aventis U.S. LLC2010-06-17Not applicableUS flag
JevtanaSolution40 mg / mLIntravenousSanofi Aventis2011-08-23Not applicableCanada flag

Categories

ATC Codes
L01CD04 — Cabazitaxel
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as taxanes and derivatives. These are diterpenoids with a structure based either on the taxane skeleton, or a derivative thereof. In term of phytochemistry, several derivatives of the taxane skeleton exist: 2(3->20)-abeotaxane, 3,11-cyclotaxane, 11(15->1),11(10->9)-abeotaxane, 3,8-seco-taxane, and 11(15->1)-abeotaxane, among others. More complex skeletons have been found recently, which include the taxane-derived [3.3.3] propellane ring system.
Kingdom
Organic compounds
Super Class
Lipids and lipid-like molecules
Class
Prenol lipids
Sub Class
Diterpenoids
Direct Parent
Taxanes and derivatives
Alternative Parents
Benzoic acid esters / Tricarboxylic acids and derivatives / Benzoyl derivatives / Fatty acid esters / Monosaccharides / Tertiary alcohols / Carbamate esters / Secondary alcohols / Oxetanes / Carboxylic acid esters
show 8 more
Substituents
Alcohol / Aromatic heteropolycyclic compound / Benzenoid / Benzoate ester / Benzoic acid or derivatives / Benzoyl / Carbamic acid ester / Carbonic acid derivative / Carbonyl group / Carboxylic acid derivative
show 22 more
Molecular Framework
Aromatic heteropolycyclic compounds
External Descriptors
tetracyclic diterpenoid (CHEBI:63584)
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
51F690397J
CAS number
183133-96-2
InChI Key
BMQGVNUXMIRLCK-OAGWZNDDSA-N
InChI
InChI=1S/C45H57NO14/c1-24-28(57-39(51)33(48)32(26-17-13-11-14-18-26)46-40(52)60-41(3,4)5)22-45(53)37(58-38(50)27-19-15-12-16-20-27)35-43(8,36(49)34(55-10)31(24)42(45,6)7)29(54-9)21-30-44(35,23-56-30)59-25(2)47/h11-20,28-30,32-35,37,48,53H,21-23H2,1-10H3,(H,46,52)/t28-,29-,30+,32-,33+,34+,35-,37-,43+,44-,45+/m0/s1
IUPAC Name
(1S,2S,3R,4S,7R,9S,10S,12R,15S)-4-(acetyloxy)-15-{[(2R,3S)-3-{[(tert-butoxy)carbonyl]amino}-2-hydroxy-3-phenylpropanoyl]oxy}-1-hydroxy-9,12-dimethoxy-10,14,17,17-tetramethyl-11-oxo-6-oxatetracyclo[11.3.1.0^{3,10}.0^{4,7}]heptadec-13-en-2-yl benzoate
SMILES
[H][C@]12[C@H](OC(=O)C3=CC=CC=C3)[C@]3(O)C[C@H](OC(=O)[C@H](O)[C@@H](NC(=O)OC(C)(C)C)C4=CC=CC=C4)C(C)=C([C@@H](OC)C(=O)[C@]1(C)[C@H](C[C@H]1OC[C@@]21OC(C)=O)OC)C3(C)C

References

Synthesis Reference

Nagesh Palepu, "CABAZITAXEL FORMULATIONS AND METHODS OF PREPARING THEREOF." U.S. Patent US20120065255, issued March 15, 2012.

US20120065255
General References
  1. Galsky MD, Dritselis A, Kirkpatrick P, Oh WK: Cabazitaxel. Nat Rev Drug Discov. 2010 Sep;9(9):677-8. doi: 10.1038/nrd3254. [Article]
  2. Kort A, Hillebrand MJ, Cirkel GA, Voest EE, Schinkel AH, Rosing H, Schellens JH, Beijnen JH: Quantification of cabazitaxel, its metabolite docetaxel and the determination of the demethylated metabolites RPR112698 and RPR123142 as docetaxel equivalents in human plasma by liquid chromatography-tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. 2013 Apr 15;925:117-23. doi: 10.1016/j.jchromb.2013.02.034. Epub 2013 Mar 5. [Article]
  3. Nightingale G, Ryu J: Cabazitaxel (jevtana): a novel agent for metastatic castration-resistant prostate cancer. P T. 2012 Aug;37(8):440-8. [Article]
Human Metabolome Database
HMDB0015672
KEGG Drug
D09755
PubChem Compound
9854073
PubChem Substance
99443289
ChemSpider
8029779
RxNav
996051
ChEBI
63584
ChEMBL
CHEMBL1201748
ZINC
ZINC000085536932
PharmGKB
PA165958401
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Cabazitaxel
FDA label
Download (383 KB)
MSDS
Download (99.2 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4CompletedTreatmentMetastatic Prostate Cancer2
4CompletedTreatmentProstate Cancer2
3Active Not RecruitingTreatmentAdenocarcinoma of Prostate / Progression of Prostate Cancer1
3CompletedTreatmentMetastatic Prostate Cancer2
3CompletedTreatmentNeoplasm / Neoplasms of the Prostate1
3CompletedTreatmentProstate Cancer3
3RecruitingTreatmentMetastatic Castration-Resistant Prostate Cancer (mCRPC) / Metastatic Hormone-Sensitive Prostate Cancer (mHSPC)1
3TerminatedTreatmentCastration Resistant Prostate Cancer / Hormone-Refractory Prostate Cancer1
3Unknown StatusOtherMetastatic Castration-Resistant Prostate Cancer (mCRPC)1
3Unknown StatusTreatmentProstate Cancer1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
Injection, solutionIntravenous60 mg/1.5ml
Injection, solution, concentrateIntravenous20 MG/ML
InjectionParenteral60 MG
Injection, solution, concentrateIntravenous
Kit; solutionIntravenous40 mg / mL
SolutionIntravenous45 mg / 4.5 mL
SolutionIntravenous60 mg / 6 mL
Injection, solution, concentrateIntravenous60 mg/1.5ml
Injection, solution, concentrateIntravenous10 MG/ML
InjectionIntravenous
InjectionIntravenous60 mg/1.5mL
Injection, solution, concentrateIntravenous; Parenteral60 mg/1.5ml
SolutionIntravenous40 mg / mL
Solution, concentrateIntravenous60 mg
SolutionIntravenous
InjectionParenteral60 mg/1.5ml
SolutionIntravenous60 mg/1.5ml
Injection, solution, concentrateIntravenous drip60 mg/1.5ml
SolutionIntravenous60 mg
Prices
Not Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)Region
US5438072No1995-08-012014-05-22US flag
US5698582No1997-12-162012-07-03US flag
US6372780No2002-04-162016-03-26US flag
US6387946No2002-05-142016-03-26US flag
US8927592Yes2015-01-062031-04-27US flag
US7241907Yes2007-07-102026-06-10US flag
US5847170Yes1998-12-082021-09-26US flag
US6331635No2001-12-182016-03-26US flag
US10583110No2020-03-102030-10-27US flag
US10716777No2020-07-212030-10-27US flag

Properties

State
Solid
Experimental Properties
Not Available
Predicted Properties
PropertyValueSource
Water Solubility0.00413 mg/mLALOGPS
logP3.69ALOGPS
logP4.2Chemaxon
logS-5.3ALOGPS
pKa (Strongest Acidic)11.96Chemaxon
pKa (Strongest Basic)-3.6Chemaxon
Physiological Charge0Chemaxon
Hydrogen Acceptor Count10Chemaxon
Hydrogen Donor Count3Chemaxon
Polar Surface Area202.45 Å2Chemaxon
Rotatable Bond Count15Chemaxon
Refractivity213.4 m3·mol-1Chemaxon
Polarizability86.25 Å3Chemaxon
Number of Rings6Chemaxon
Bioavailability0Chemaxon
Rule of FiveNoChemaxon
Ghose FilterNoChemaxon
Veber's RuleNoChemaxon
MDDR-like RuleYesChemaxon
Predicted ADMET Features
PropertyValueProbability
Human Intestinal Absorption+0.9535
Blood Brain Barrier-0.9825
Caco-2 permeable-0.7945
P-glycoprotein substrateSubstrate0.8287
P-glycoprotein inhibitor IInhibitor0.6646
P-glycoprotein inhibitor IIInhibitor0.5887
Renal organic cation transporterNon-inhibitor0.933
CYP450 2C9 substrateNon-substrate0.8236
CYP450 2D6 substrateNon-substrate0.882
CYP450 3A4 substrateSubstrate0.7256
CYP450 1A2 substrateNon-inhibitor0.8197
CYP450 2C9 inhibitorNon-inhibitor0.8654
CYP450 2D6 inhibitorNon-inhibitor0.8935
CYP450 2C19 inhibitorNon-inhibitor0.8429
CYP450 3A4 inhibitorNon-inhibitor0.6339
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.9068
Ames testNon AMES toxic0.8028
CarcinogenicityNon-carcinogens0.9264
BiodegradationNot ready biodegradable0.9926
Rat acute toxicity2.6378 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9907
hERG inhibition (predictor II)Non-inhibitor0.7906
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available

Targets

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Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Binder
General Function
Structural constituent of cytoskeleton
Specific Function
Tubulin is the major constituent of microtubules. It binds two moles of GTP, one at an exchangeable site on the beta chain and one at a non-exchangeable site on the alpha chain.
Gene Name
TUBA4A
Uniprot ID
P68366
Uniprot Name
Tubulin alpha-4A chain
Molecular Weight
49923.995 Da
References
  1. JEVTANA - cabazitaxel [Link]
Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Binder
General Function
Structural constituent of cytoskeleton
Specific Function
Tubulin is the major constituent of microtubules. It binds two moles of GTP, one at an exchangeable site on the beta chain and one at a non-exchangeable site on the alpha chain (By similarity).
Gene Name
TUBB1
Uniprot ID
Q9H4B7
Uniprot Name
Tubulin beta-1 chain
Molecular Weight
50326.56 Da
References
  1. JEVTANA - cabazitaxel [Link]

Enzymes

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Vitamin d3 25-hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...
Gene Name
CYP3A4
Uniprot ID
P08684
Uniprot Name
Cytochrome P450 3A4
Molecular Weight
57342.67 Da
References
  1. JEVTANA - cabazitaxel [Link]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Oxygen binding
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
Gene Name
CYP3A5
Uniprot ID
P20815
Uniprot Name
Cytochrome P450 3A5
Molecular Weight
57108.065 Da
References
  1. JEVTANA - cabazitaxel [Link]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Steroid hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
Gene Name
CYP2C8
Uniprot ID
P10632
Uniprot Name
Cytochrome P450 2C8
Molecular Weight
55824.275 Da
References
  1. JEVTANA - cabazitaxel [Link]

Transporters

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
Inhibitor
Curator comments
In vitro, cabazitaxel inhibited P-gp; however, the in vivo risk of cabazitaxel inhibiting P-gp is low at the recommended therapeutic dose.
General Function
Xenobiotic-transporting atpase activity
Specific Function
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells.
Gene Name
ABCB1
Uniprot ID
P08183
Uniprot Name
Multidrug resistance protein 1
Molecular Weight
141477.255 Da
References
  1. JEVTANA - cabazitaxel [Link]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Xenobiotic-transporting atpase activity
Specific Function
High-capacity urate exporter functioning in both renal and extrarenal urate excretion. Plays a role in porphyrin homeostasis as it is able to mediates the export of protoporhyrin IX (PPIX) both fro...
Gene Name
ABCG2
Uniprot ID
Q9UNQ0
Uniprot Name
ATP-binding cassette sub-family G member 2
Molecular Weight
72313.47 Da
References
  1. JEVTANA - cabazitaxel [Link]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Sodium-independent organic anion transmembrane transporter activity
Specific Function
Mediates the Na(+)-independent uptake of organic anions such as pravastatin, taurocholate, methotrexate, dehydroepiandrosterone sulfate, 17-beta-glucuronosyl estradiol, estrone sulfate, prostagland...
Gene Name
SLCO1B1
Uniprot ID
Q9Y6L6
Uniprot Name
Solute carrier organic anion transporter family member 1B1
Molecular Weight
76447.99 Da
References
  1. JEVTANA - cabazitaxel [Link]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Sodium-independent organic anion transmembrane transporter activity
Specific Function
Mediates the Na(+)-independent uptake of organic anions such as 17-beta-glucuronosyl estradiol, taurocholate, triiodothyronine (T3), leukotriene C4, dehydroepiandrosterone sulfate (DHEAS), methotre...
Gene Name
SLCO1B3
Uniprot ID
Q9NPD5
Uniprot Name
Solute carrier organic anion transporter family member 1B3
Molecular Weight
77402.175 Da
References
  1. JEVTANA - cabazitaxel [Link]

Drug created at September 14, 2010 16:21 / Updated at June 03, 2023 08:16