My husband is wrestling with a looming recommendation of a second course of chemo with carboplatin. He did Taxotere early on (CHAARTED protocol). Did great on Xtandi for 2 years, now trying Zytiga (although we've been told it might not work, or work for long). He's resisting the idea of chemo because he thinks he will feel like crap during the chemo and won't get any real quality of life benefit after that -- just a longer, suffering life.
Note: He is only 56, very healthy otherwise, but his blood values really suffered during the Taxotere, and also the RA223/Xofigo therapies. He got Neupogen which kept him on schedule with the chemo (so I guess not as bad as some people) but his low blood counts get him really anxious.
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If he gets immunotherapy (like Provenge) at the same time, it may improve both. Provenge will amp up his immune system so there will be less myelosuppression from the chemo, and the chemo will destroy cancer cells thereby putting more cancer antigens in his bloodstream. The newly activated T cells can will get keyed into the new antigens and destroy more cancer cells throughout his body.
Also, is the reason for carboplatin due to some other type of prostate cancer being identified? If so, he may be eligible for a PARP inhibitor trial. I'm not sure if its effectiveness or side effect profile is any better.
Already did Provenge. Mostly, he's done everything. He's been checked for the genetic markers that are known to be related -- doesn't have any so the PARP stuff is not relevant. We have asked the Prostate Cancer expert we work with at UCSF and he said the massive genomics test is not worth it because anything beyond the known ones (like PLD-1) is really just a guess at this point. But thanks for the suggestions.
Thanks. We had some basic genetic mapping done, including PDL-1. Waiting to see if a tumor gets large enough to try a direct sample, but so far -- no genetic markers for my husband generally, and likelihood of being on tumor is small. Thanks for the suggestion.
Nalakrats, thanks for the information. I am currently looking at the options now for gene mapping.
Like many, I will end up paying for this myself. Do you have any idea what the cost is?
Nalakrats, my profile needs to be updated, but my PSA is slowly starting to rise. It's still low, but now is a good time for me to do it.
Thanks for all the useful information, though I would like to add that if you are using old tissue from a biospy for testing, it may not have the most recent somatic mutations which have occurred. The whole idea of the testing is to see which mutaions have developed during treatment. Some could be inherited (germline) but others develop over the course of treatment (somatic).
Hi, My name is Lynn, husband did chemo, been n Zytsga, Xtandi also. Sam started at age 65 now74 young. This past operation he had a cancerous LN removed, his mutations qualified him for two plus
Targeted therapy drugs. Sunitinib and Cabozantinib,these were two of the drugs that his oncologist wanted for him. I never heard of either but they both are FDA approved?? Waiting to hear if we can get one?? One drug co. already said they had no gov.. grants ?? I read that these targeted therapy drugs are a game changer for men with late stage PC . Sam had LN out right after Christmas, took a few weeks to get biopsy results back. His PSA was 65 in Janauary, this past week it's up to a 100.00.
Still waiting and nervous to see if we can get one of these drugs.
Wishing you and your husband best wishes and keep me and the rest posted!!
We always have hope and there are always new treatments being made.
I have been in this battle for almost 6 years (please see bio for complete treatment history).
Just completed 6 cycles of chemo with Docetaxel/Carboplatin combo, as I now have prostate cancer mets in liver.
PSA was 10.8 before chemo and dropped to .4 after 6 cycles. Always left infusion center with an On Body Injector of Neulasta to boost white blood cells.
Overall not too bad. On a chemo break, currently at 2 months!
Congrats on the PSA plunge. How are you feeling? I know that during the chemo you just take whatever you can get -- but is the after effect worth it? That is my husband's concern. Thanks for sharing your experience. - Brenda
Still have some fatigue but hair is growing back! I iced hands and feet during Docetaxel infusion to mitigate peripheral neuropathy, but Carboplatin does not have that side effect.
One other thought--Guardant360 liquid biopsy requires only 2 vials of blood and will look for genetic defects. One of mine revealed an ATM defect and Dr. "Snuffy " Myers could prescribe Lynparza, a PARP inhibitor.
My father 79y/p on carboplatin and has minimal side effects (constipation) and besides the usual fatigue with Lupron. Hemoglobin has dropped but wbc have been normal with neulasta. Mild hair loss, no changes in taste or neuropathy as of yet. We do ice his hands and feet. Good luck to your husband lots of hugs and prayers!
My husband is on Carbo Platin. Apart from tiredness and the need for more sleep he doesn't feel bad at all. In fact, he feels a lot better than he has done in a long time. This Chemo is really working for him. So, if I were your husband, I would try it.
Thanks. We have pushed chemo off with trying Zytiga first (after Xtandi stopped working). Here's hoping we get some time out of it. But good to know this because it's coming. Glad it's working so well for your guy!
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