Docetaxil and carboplatin

[Rexwaterbury]

I saw dr Drake today and this is his recommendation. Does anyone have experience with this combination?

[Tall_Allen]

Were you diagnosed with neuroendocrine PC or a problem with DNA repair genes?

[Rexwaterbury in reply to Tall_Allen]

I had a lymph node biopsy 2 months ago that showed adenocarcinoma. No neuro endocrine or small cell carcinoma. I have a PSA doubling time of one month, and that is why Dr. Drake wants to take an aggressive approach.

[Hidden in reply to Rexwaterbury]

Another thing your doctor may be looking at is the time from diagnosis to castrate resistance. If it is short, chemotherapy is prefered over second line ADT.

[tango65 in reply to Rexwaterbury]

If you do not have neuroendocrine PC, perhaps you should consider the clinical trials for Lu 177 PSMA and Ac 225 PSMA:

healthunlocked.com/advanced...

before doing cisplatin and docetaxel or paclitaxel. Carboplatin may have has much more negative side effects than Lu 177 PSMA treatment:

chemocare.com/chemotherapy/...

[Tall_Allen in reply to Rexwaterbury]

I'm not sure that adding carboplatin is "aggressive." Has he seen patients with adenocarcinoma and no genomic markers who have responded to this?

[Hidden in reply to Tall_Allen]

There was small phase 2 trial that was done to compare rechallenge with Docetaxel to rechallenge with Docetaxel plus Carboplatin. These were randomly selected patients, not tested for any proven indications for Carboplatin. They found no improvement with Carboplatin, just more toxicity.

Of course if you have the indications of either DNA repair gene mutations or Neuroendocrine Differentiation, then Carboplatin is useful.

Here's an article:

ascopubs.org/doi/abs/10.120...

[HOPEFULSPOUSE]

My husband's MO started him on low-dose taxotere with the idea that he would eventually add carbo. But he ended up switching to Jetvana so did not receive the combo. It is rather powerful from what I understand and not always well tolerated.

[vandy69]

I have had 12 infusions with Docetaxel/Carboplatin combo, over the course of 2 treatments of 6 cycles each. First was in September 2017 when I was diagnosed with 20+ lesions in my liver, in addition to those mets already in lymph nodes. Treatment was successful with PSA dropping and liver lesions becoming smaller. MO next tried a rechallenge with Xtandi which gave me about 4 months of lower and stable PSA. PSA began to rise, of course, so we did a second round of Docetaxel/Carboplatin. Not quite as successful as first time but everything went the right way. Once off chemo, PSA shot up from 4.7 to 48. Second rechallenge with Xtandi brought it down to 30 so far.

For chemo, MO used Aloxi as first drip to prevent nausea. Always left chemo with On Body Injector of Neulasta to boost white blood cells.

Best wishes. Never Give In.

Mark, Atlanta

[paulcross4]

I’m on that combination. Cycle 5 today. Has brought my PSA down significantly , removed all pain from multiple bone Mets and side effects have been very manageable. Have been able to work and continue normal life though it without too much difficulty.

[Rexwaterbury in reply to paulcross4]

Thanks for the reply. Who is your MO?

[paulcross4 in reply to Rexwaterbury]

Srinivas at Stanford and Argawall at UCSF

[Rexwaterbury]

Are you a candidate for the Lu177 and Keytruda trial at UCSF, or did the chemoRx exclude you.