Dr. Schweizer on the Rationale for the CARD Trial in mCRPC

Michael Schweizer, MD, a physician of the Seattle Cancer Care Alliance, assistant professor in the Division of Medical Oncology at the University of Washington School of Medicine, and associate professor in the Clinical Research Division of the Fred Hutchinson Cancer Research Center, discusses the rationale for the phase 3 CARD trial in metastatic castration-resistant prostate cancer (mCRPC). 

The CARD trial randomized men with mCRPC to receive either cabazitaxel (Jevtana), or abiraterone acetate (Zytiga) or enzalutamide (Xtandi), depending on which androgen signaling inhibitor patients had received previously.

Retrospective analyses have suggested that when drugs like abiraterone or enzalutamide are used sequentially, the second used is not as effective, Schweizer says. Antiandrogens have similar mechanisms of action and work to shut down the androgen receptor–signaling pathway. As such, cross resistance and diminished clinical activity are likely results of sequentially use, Schweizer explains. 

The CARD trial was designed in response to these findings; investigators evaluated whether cabazitaxel could replace a second antiandrogen in patients who had progressed on abiraterone or enzalutamide, concludes Schweizer.