Chemo after zytiga

[Peterd110]

I’ve seen several who have done well with zytiga/Xtandi after initial treatment with chemo, but what about efficacy of chemo after initial treatment with zytiga? I have a feeling of doom after failing zytiga in just 1.5 years.

[Grumpyswife]

I think that order of treatment is common, especially if you have exhausted other treatment options and it might help to slow the cancer down.

[Peterd110 in reply to Grumpyswife]

Zytiga has been my only treatment with Adt shots since diagnosis (with the exception of casodex for a couple weeks until zytiga was approved by insurance)

[Cynthgob in reply to Grumpyswife]

Is cabizitazel as hard on you as docetaxel? I’ve had docetaxel and zytiga. Wondering if I even want to do more chemo?? Zytiga for 14 months now but afraid it’s failing.

[Tall_Allen]

The efficacy of cabazitaxel is unaffected by previous Zytiga/Xtandi.

[Peterd110 in reply to Tall_Allen]

What about docetaxel?

[Tall_Allen in reply to Peterd110]

I would prefer cabazitaxel after Zytiga/Xtandi.

ncbi.nlm.nih.gov/pubmed/311...

[Peterd110 in reply to Tall_Allen]

Thanks!

[Blueslover in reply to Tall_Allen]

Read a recent article that recommended the use of Taxotere at any metastatic stage in order to slow down any further metastasis.

Comments Dr.?

[Tall_Allen in reply to Blueslover]

I'm not a doctor. Yes, docetaxel is good for metastatic hormone-sensitive PC and metastatic castration-resistant PC. It is good whether metastatic burden is high or low. Cabazitaxel is good after docetaxel stops working.

[Blueslover in reply to Tall_Allen]

Sorry, I thought you were but thanks for the reply

Hugh

[FightTillTheEnd in reply to Peterd110]

I second Tall Allen on this one. I'm on a second round of Cabazitaxel after having gone through rounds of Xtandi and Zytiga. I seem to be doing good in terms of efficacy. Not sure what will come after though...

[Cynthgob in reply to FightTillTheEnd]

Side effects?

[FightTillTheEnd in reply to Cynthgob]

Bit of nausea for a few days after treatment. And the usual (on day 4/5 after chemo) of what feels like bone pain, hair loss, taste loss...

[FightTillTheEnd in reply to Tall_Allen]

Hi Tall Allen, any idea what would / could come after Cabazitaxel? I'm just wondering....Busy with a second round of Cabazitaxel (6 sessions each) and I'm not sure what the MO will propose after that. Thanks

[Tall_Allen in reply to FightTillTheEnd]

What have you had?

[FightTillTheEnd in reply to Tall_Allen]

Had chemo first (I need to double check which one because I can't recall the name now). Then Casodex, then Xtandi, then Zytiga and now Cabazitaxel. And Zoladex every 3 months

[Tall_Allen in reply to FightTillTheEnd]

Do you have bone metastases without visceral metastases - if so, Xofigo and Provenge may be good choices.

[FightTillTheEnd in reply to Tall_Allen]

There are bone and a couple of visceral mets. Xofigo was mentioned in the past by my MO because it's mainly bone mets but we haven't gone down that road yet because of some visceral involvement.

[Tall_Allen in reply to FightTillTheEnd]

Yes- insurance probably won't cover it if there are visceral metastases.

[Peterd110 in reply to FightTillTheEnd]

Have you tried a re-challenge with zytiga/Xtandi by any chance?

[FightTillTheEnd in reply to Peterd110]

Not yet, I have a feeling it may come after this round of Cabazitaxel.

[Grumpyswife in reply to FightTillTheEnd]

My husband's MO was discouraging about chemo for my 76 yo husband. He questioned why the need for chemo and the possible side effects when my husband is enjoying a good quality of life--except for the damage inflicted by previous treatments.

The answer is that most everyone wants to stay above ground. Since the MO is also a palliative care specialist you'd think he would realize that.

We will get a second opinion regarding chemo side effects in the elderly or other treatment options he might try.

Are any of you posting older?

[FightTillTheEnd in reply to Grumpyswife]

Might be the reason why my MO is okay with chemo for me. I'm almost 43 years old so his thinking is probably I can take the beating because of my age.

In my case it's simple, the chemo is working when Zytiga and Xtandi stopped working. I'll put up with the standard chemo side effects for more time with my family.

I would also say that my quality of life is better on chemo that on ADT's. For some reason, when I'm on chemo, the debilitating back pain seems to go away too. I get more quality time with my wife and kids and I'm travelling more extensively with my family making fabulous memories. I'll take these small wins where I can

[Peterd110 in reply to Grumpyswife]

I’m 66. 64 at diagnosis