Cabazitaxel-induced ureteritis in metastatic castration-resistant prostate cancer patients: a single center case series 2014–2024

Background: One of the main and effective therapy choices for patients with metastatic castration-resistant prostate cancer (mCRPC) is cabazitaxel (CBZ). Cystitis and hematuria are among the most significant non-hematological adverse events associated with CBZ treatment. But because the prevalence of CBZ-induced ureteritis has not been thoroughly studied, this case series investigation was carried out to emphasize the condition’s clinical relevance and potential treatment alternatives. Case presentation: Between June 2014 and May 2024, 354 patients diagnosed with mCRPC were treated with CBZ at the Department of Oncology, Vejle Hospital. A total of 36 patients (10%) exhibited ureteritis-like symptoms, presenting with discomfort in the pelvis, lower abdomen, or flanks, with or without hematuria. Radiological evidence of ureter changes was present in 29 out of 36 individuals (80%), along with hydronephrosis/hydroureter in some patients. Prior to therapy with CBZ, radiation to the pelvis or lower abdomen was documented in 7 out of 36 patients (19%). Various analgesics and dosage modifications were considered for the therapy of CBZ-induced ureteritis, with treatment discontinuation yielding the most favorable results. Conclusion: The onset of ureteritis during CBZ treatment is an underrated side effect in clinical practice. Hematuria and hydronephrosis/hydroureter are the most associated complications. Both analgesics and dosage reduction should be contemplated for management, while therapy cessation may be requisite in certain individuals.