Cabazitaxel [CABA1]

Cabazitaxel for hormone-relapsed metastatic prostate cancer treated with docetaxel

  1. I confirm that an application has been made and the first cycle of systemic anti-cancer therapy will be prescribed by a consultant specialist specifically trained and accredited in the use of systemic anti-cancer therapy.
  2. I confirm the patient has hormone-relapsed metastatic prostate cancer.
  3. I confirm the patient has received 225mg/m/sq or more of docetaxel and the disease has progressed during or after docetaxel chemotherapy.
  4. I confirm cabazitaxel is to be prescribed in combination with prednisone or prednisolone.
  5. I confirm the patient has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  6. I confirm the patient has been informed that treatment with cabazitaxel will be stopped if the disease progresses or after a maximum of 10 cycles (whichever happens first).
  7. I confirm the licensed dose and frequency of cabazitaxel will be used.

[NHS funded]{.badge .rounded-pill .bg-success} From: 25 May 2016

Form version:

CDF Managed Access: NA

NICE Technology Appraisal: TA391 (25 May 2016)

Current Form Version

Important

This is an older version of the form. To view the most up to date form follow this link

Older Form Versions

There are previous versions of this form. These may not all be available on this site.