Cabazitaxel

Cabazitaxel is a type of chemotherapy . You pronounce cabazitaxel as car-baz-i-tax-el. It is also known as Jevtana.

You might have it as a treatment for prostate cancer that has spread (advanced prostate cancer).

How does cabazitaxel work?

Cabazitaxel works by stopping cancer cells from separating into two new cells. This blocks the growth of the cancer. 

How do you have cabazitaxel?

You have cabazitaxel as a drip into your bloodstream (intravenously).

You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:

• central line
• PICC line
• portacath

How often do you have cabazitaxel?

You have cabazitaxel in cycles of treatment . Each cycle is a 3 week period. This means that you have a cabazitaxel drip once every 3 weeks. You have up to 10 cycles.

You also take steroids (prednisolone) as tablets every morning, after breakfast. 

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

What are the side effects of cabazitaxel?

Side effects can vary from person to person. They also depend on what other treatments you're having. 

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

• you have severe side effects 

• your side effects aren’t getting any better

• your side effects are getting worse

Early treatment can help manage side effects better. 

We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.

Common side effects

These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:

Risk of infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Breathlessness and looking pale

You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.

Bruising and bleeding

This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).

Loss of appetite and weight loss

You might not feel like eating and may lose weight. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss. 

Diarrhoea or constipation

Tell your healthcare team if you have diarrhoea or constipation. They can give you medicine to help. 

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.

Joint or back pain

You might have pain in your back or joints. Speak to your doctor or nurse about what painkillers you can take to help with this.

Blood in your urine

This can be caused by different reasons, including infection. Tell your doctor if you see blood in your urine or have any pain.

Tiredness and weakness

You might feel very tired and as though you lack energy.

Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

• allergic reaction. You have medicine before you have cabazitaxel to reduce the risk of a reaction. Tell your doctor straight away if you feel short of breath, itchy, hot or shivery, or have a rash.
• blood clots that are life threatening; signs are pain, swelling and redness where the clot is. Feeling breathless can be a sign of a blood clot on the lung. Contact your advice line or doctor straight away if you have any of these symptoms.
• an irregular or very fast heart rate. Tell your doctor or nurse if you feel dizzy, short of breath or tired or your heart feels like it’s pounding or fluttering, or you have any chest pain.
• numbness, tingling or a burning feeling in the hands and feet
• headaches
• dizziness or feeling like you or everything around you is spinning. Don’t drive or operate heavy machinery if you feel dizzy.
• changes to your blood pressure
• tummy problems which include pain, feeling bloated, burping or heartburn
• dry throat, sore throat or both
• swollen veins in or around your anus (called piles or haemorrhoids) which can be painful and may bleed slightly when you open your bowels. A cream from your pharmacist can help. Tell your doctor or nurse straight away if you have a lot of bleeding.
• feeling pain in muscles or having muscle spasms
• feeling pain or having difficulty passing urine, or leaking urine (incontinence)
• swelling, usually in arms and legs (oedema)
• skin changes such as dry or red skin
• changes to the nails
• mood changes such as feeling confused or anxious
• not enough fluid in the body (dehydration)
• high blood sugar levels
• low potassium levels in your blood
• watery eyes or redness and inflammation of the eye (conjunctivitis)
• changes to taste
• hair loss or thinning
• difficulty staying or getting to sleep
• sudden feeling of warmth around the head, neck and chest (hot flush)
• breathlessness, a cough or both
• chills
• changes to how the liver works. This shows up on a blood test result.

Rare side effects

This side effects happens in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:

• serious reaction to an infection. Signs can include feeling very unwell, not passing urine, being sick, a very high or very low temperature or shivering. Contact your advice line or healthcare team straight away if you have any of these symptoms.
• your kidneys stop working properly (renal failure)
• not able to pass urine due to a blockage. Tell your doctor or nurse if you are not able to pass urine.
• ringing in your ears (tinnitus)
• bowels not working properly. Tell your healthcare team about any changes to your bowel habits.
• inflammation of the stomach, bleeding from the stomach or both
• a tear or hole in the stomach, bowels or both
• pain, weakness, numbing of the leg

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do you need to know?

Other medicines, foods and drinks

Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.

Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.

Loss of fertility

You may not be able to get someone pregnant after treatment with this drug. Talk to your doctor before starting treatment if you think you want to have a baby in the future. You may be able to store sperm before starting treatment.

Contraception and pregnancy

This treatment might harm a baby developing in the womb. It is important not to father a child while you are having treatment and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Treatment for other conditions

If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.

You can have:

• other vaccines, but they might not give you as much protection as usual
• the flu vaccine (as an injection)
• the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment

Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your immune system recovers from treatment.

Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

More information about this treatment

We haven't listed all the very rare side effects of this treatment. For further information see the electronic Medicines Compendium (eMC) website.

You can report any side effect you have that isn’t listed here to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.