CASCARA: Castration Sensitive Carboplatin, Cabazitaxel and Abiraterone

Inclusion Criteria:

Willing and able to provide, or have a legally authorized representative provide, written informed consent and HIPAA authorization for the release of personal health information. A signed informed consent must be obtained before screening procedures are performed.
Histologically confirmed prostate cancer.
High volume metastatic disease (defined as the presence of visceral metastases or ≥3 bone lesions).
ADT for ≤3 months by day 1 of study chemotherapy; Prior episodes of ADT are allowed (i.e. ADT used previously in courses of radiation).
Testosterone <50 ng/dL. Patients must continue primary ADT with an LHRH analogue if they have not undergone orchiectomy.
ECOG Performance Status 0 or 1 (see Appendix A)

Patient has adequate bone marrow and organ function as defined by the following laboratory values:

Absolute neutrophil count ≥ 1.5 × 10^9/L
Platelets ≥ 100 × 10^9/L
Hemoglobin ≥ 9 g/dl
Serum creatinine ≤ 1.5mg/dL or estimated creatinine clearance ≥ 50 ml/min
In the absence of liver metastases, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) <2.5 x ULN. If the patient has liver metastases, ALT and AST <5 x ULN
Total bilirubin < ULN; or total bilirubin ≤3.0 x ULN or direct bilirubin ≤1.5 x ULN in patients with well-documented Gilbert's Syndrome.
Sexually active males must use a condom during intercourse while taking study drugs and for 30 days after stopping treatment and should not father a child in this period. A condom is required to be used also by vasectomized men in order to prevent delivery of the drug via seminal fluid. Fertile males must use a condom with spermicide (double barrier method).
Age ≥ 18 years

Exclusion Criteria:

Prior exposure to any chemotherapy, PARPi, or immunotherapy for prostate cancer.
Prior abiraterone or enzalutamide, unless therapy was for < 2 weeks
Radiation therapy (including palliative radiotherapy to a metastatic lesion) within 14 days or major surgery (e.g., open abdominal, pelvic, thoracic, orthopedic or neurosurgery) within 28 days of the date of the first dose.
Other systemic therapies for prostate cancer within 28 days or 5 half-lives, whichever is shorter, prior to day 1 of chemotherapy (with the exception of anti-androgens like bicalutamide).
PSA <2.0 ng/mL at diagnosis.
If present, peripheral neuropathy must be ≤ Grade 1
Patients with an active second malignancy that could, in the investigator's opinion, potentially interfere with the patient's ability to participate and/or complete this trial.

Patients with central nervous system (CNS) involvement unless they meet ALL of the following criteria:

At least 4 weeks from prior therapy completion (including radiation and/or surgery) prior to starting the study treatment
Clinically stable CNS tumor at the time of screening.
Baseline screening for CNS metastases is not required unless presence of signs and/or symptoms of involvement
Patients with severe psychiatric illness/social situations that would limit compliance with study requirements in the judgment of treating investigator.
Patient has a history of non-compliance to medical regimen or inability to grant consent.