Cabazitaxel is a semi-synthetic taxane anticancer drug developed for the treatment of metastatic castration-resistant prostate cancer (mCRPC), particularly in patients who have progressed after docetaxel therapy. As a member of the taxane family, cabazitaxel works by stabilizing microtubules and inhibiting cell division, leading to cancer cell death. Unlike earlier taxanes, cabazitaxel has low affinity for the P-glycoprotein drug efflux pump, a key mechanism responsible for chemotherapy resistance, which allows it to remain effective in tumors that no longer respond to docetaxel. The drug was developed in the late 1990s by Sanofi-Aventis (initially known as XRP6258) through structural modification of existing taxanes to overcome multidrug resistance. Preclinical studies demonstrated strong antitumor activity in docetaxel-resistant cancer models, leading to clinical trials in the early 2000s. Its clinical significance was established by the Phase III TROPIC trial, which showed improved overall survival compared to mitoxantrone in previously treated mCRPC patients. Based on these results, cabazitaxel received FDA approval in 2010, marking an important advancement in prostate cancer chemotherapy and highlighting the evolution of taxane development to address drug resistance.
