Technology Appraisal Guidance No. 391
Source: National Institute for Health and Care Excellence
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 of the full guidance 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.
The guidance shown above constitutes Section 1 of the full document. A copy of the full document and a summary of the evidence is available on the Internet at
This guidance represents the view of the Institute which was arrived at after careful consideration of the available evidence. Health professionals are expected to fully take it into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of health professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
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Enquiries concerning the guidance should be addressed to: National Institute for Health and Care Excellence, MidCity Place, 71 High Holborn, London WC1V 6NA. email:
Cabazitaxel for hormone-relapsed metastatic prostate cancer treated with docetaxel
Issue Date: May 2016 (updated August 2016)