Docetaxel rechallenge

Hi all, I'm considering speaking with my MO about a possible Docetaxel rechallenge. My last Docetaxel (5 years ago) session of 6 courses brought my psa down to 0.05 from the 700's. I'm finishing my Provenge treatment this week and being that my psa is on the rise, (0.9), I'm at a crossroads. Does anyone have a Docetaxel rechallenge story to share? Thank you.

[Tall_Allen]

Good choice, especially immmediately after Provenge

[Hidden in reply to Tall_Allen]

Thanks for the reply, would it be the same protocol, meaning 6 courses 3 weeks apart? Last go around I needed Neulasta due to very low wbc/anc counts.

[Tall_Allen in reply to Hidden]

I reckon so, but that's up to you and your oncologist. You may not need Neulasta if you do it soon after Provenge because Provenge already includes GM-CSF.

[Hidden in reply to Tall_Allen]

Thanks for your time and knowledge, appreciated.

[Fairwind]

Go for it but be aware there are limits as to how much chemo your body will tolerate. it tends to be cumulative..Let your body tell you when enough is enough..

[paulparry]

Not sure what you mean by re-challenge but I have had 2 rounds of Docataxel.

Round 1 for 10 sessions and resulted in PSA 0.01 and possible recovery. However within 7 months a spinal cord compression meant that there were obviously still cancer cells doing their work.

2 round of 6 again reduced PSA under 0.5 but it is still growing as it started doubling within another 7 months.

When PCa reacts then my treatment goes with it.

If at this point you feel PSA is rising and I use the PSA markers of under 1 no problem 3,5 then watching. Over 10 then discuss the situation.

As we are aware its about rising PSA so monitor the trend.

[Hidden]

You have been one of the lucky ones to get a good response from Docetaxel. I would suggest now is the time to get some IV C going as you have the luxury of a little time to experiment to delay more problematic treatments. You may have to find an oncologist who uses much smaller doses of Docetaxel combined with Vit C to get an enhanced effect with much less potential problems. A full blast of Docetaxel may have a totally different effect this time around. Good luck!

[Gildot]

We just wrapped up a rechallenge for my dad - but cut it short at 6 instead of trying for 10 (initial plan). It worked great lowering PSA again, but the scans will tell us more, because we can't go by PSA because he has the rare aggressive type that does not produce PSA normally. We stopped to take quality of life breather. Not sure what's next.

[Hidden in reply to Gildot]

Thank you. May I ask what his psa was "before and after"?

[Gildot in reply to Hidden]

It was close to 4 when we started and got down to around .4 with each treatment lowering more..

[Pkhughes]

Just following

[MateoBeach]

A comment from my MO mentioned that Docetaxel rechallenge off ADT after becoming castrate resistant may restore some degree of androgen deprivation response. I don't know the source study on this. I guess it would mean that the androgen independent cell population may be more sensitive to chemotherapy because of the increased metabolic demands of being androgen independent. (upleveling AR receptors, autonomous androgen synthesis, etc.) Worth a try!