My husband is running out of options, as he's tried just about every thing that's out there for his cancer. He's been on Zytiga for nearly a year, after doing well on Taxotere for
almost a year. Zytiga started losing its punch a few months ago, and his PSA has gone from 140 to 200. Med. onc. is recommending the Mitoxantrone, but he must have an echocardiogram first because the med can impact one's heart. Oh, joy....not! Husband is pretty discouraged. He's been fighting his cancer for close to 6 years. Had the robotic surgery in 11/11; Gleason 9 with 2 positive lymph nodes. Just trying to find someone else who has tried Mitoxantrone [Novantrone]. Thanks.
Jeanne
Written by
jmatson
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There may be few here who have recently had any direct experience with Mitoxantrone; however, here is a link to a US FDA Postmarket Drug Safety Information Sheet, originally published in 2008, and updated in 2015, which has more information about the drug, it's possible effects on the heart, and the recommended monitoring of Left Ventricular Ejection Fraction (LVEF) both before, during, and after administration.
Near the bottom of this link is a Calculator (click on the symbol) related to determining the recommended dose of the drug for Prostate Cancer treatment, based on body measurements.
Finally, here's the full Web version of the Prescribing/Package Insert, containing sections specific to Prostate Cancer (probably better to read this one first):
The original patent exclusive rights for this older drug expired in 2006, so be sure to check your Insurance Formularies and any pharmacy sources for a possibly cost-saving generic version.
Has he already had or considered the option of Jevtana (cabazitaxel)? Does he have symptomatic bone mets but insignificant visceral disease, perhaps opening Xofigo (Rad 223) as an option? Did he consider, try, or fail Xtandi (enzalutamide)? Has he considered any second opinion consultations from any of the research centers, and asked for their recommendations in regards to possible Clinical Trials? Genetic testing? Immuno-agents in development?
Just some more thoughts before you might make a decision as to a "next step" along your journey.
By the way, I love your photo of the two of you in front of what appears to be the Grand Canyon.
Yes, that's the GC! It was my first time visiting the canyon; Jim's 2nd time. Jim has been on about everything--Xtandi, Zytiga, Xofigo, Taxotere (1 year). We keep hoping something new will arrive and be available to him. It's trying times for us. Plus, he tripped over a gasoline hose about a week ago and fractured his upper arm. Fortunately it is healing nicely.
Mitozantrone, was the standard of care for chemo before taxotere was approved, currently Javenta is second line chemo to taxotere, but more toxic, Mito was used as second line for many years before Javenta was approved. I am wondering why he would not try xtandi an oral med, also be aware after a time off taxoter you can rechallange and still get a response. I plan to try xtandi and zytiga again after I have been off for over a year and if failing chemo.
As I am sure you will appreciate, comments relating to treatments are purely a pointer as to what you might discuss with your oncologist..
I assume your husband treatment thus far has consisted of abiraterone acetate plus prednisone.
Whilst prednisolone is the most commonly used corticosteroid with abiraterone particularly in clinical trials - and is the standard of care as recommended by current guidelines, two recent trials have shown better response rates and progression-free survival when dexamethasone is used with abiraterone rather than prednisone.
It could be the side effects will not be as drastic as swinging across to treatment with Mitoxantrone and it might prove to be a worthwhile interim holding measure.
Another treatment that you might wish to research is the PPRT Peptide Receptor Radionuclide Therapy trials using Lutetium 177 which might well be suitable for someone with your husbands prognosis. I understand four trials are just getting underway. I have been treated with Lutetium177 and it proved to be very effective on both soft tissue and bony metastasis.
I'm here for my husband also, but I had novatrone 3 times several years ago for my multiple sclerosis. It's been used for MS for years, but that's another story. It's use had a life long dosage limt because of it's likely cardiac effects. My only effect was blue urine for 24 hours so I stopped the treatment.
I am thankful for this site for all the info and support offered. I'm no longer able to learn, but i wonder if there are more options for your husband's treatment. Also, some things used before can become effective again later. Keep looking, asking, and listening.
Time out, 2cat. "I'm no longer able to learn", is not an option. We can, and usually do, learn things all the time. Let's not belittle ourselves because we're older or have a disease. Tally-ho!
I wish, Joe. I've lost many brain and memory cells due to 20 years with Multiple Sclerosis. l manage when supervised yet cause some laughs. I'm lucky but it's more frustrating since my husband's cancer. I forget my research and questions for his doctors. Thanks for the comment and Tally-ho.
Faith, I'm sorry that you've had to deal with such a nasty disease. For somebody to laugh about it, is cruel. I wish you and your husband the best wishes for the future.
No worries about the laughs. Sometimes what comes out of my mouth is too funny and it's between family in fun. Other examples are just taken in stride. I don't ask what people think. After I retired I heard some co-workers thought I was drinking. I certainly walked like it and still do. Ready for a cop to notice but I quit driving. We laugh a lot.
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