Jevtana or wait

[Buzy1]

My oncologist is recommending Jevtana as my next step. I have bone mets in several areas. Presently I am in good health with no pain. Do I start chemo or do I wait? Has anyone had good results with Jevtana? Help!

[Hidden]

I would make that decision based on the progression of the cancer with imaging plus other symptoms. I would also look Alk Phos and of course PSA. What are the current numbers and have they been going up?

[Buzy1]

PSA 238 Alk Phos 183

[Tall_Allen]

I don't understand. Why would you wait? It works best and has fewer side effects if used earlier.

[Buzy1 in reply to Tall_Allen]

I have not heard of any success stories. All Taxotera did was reduce my PSA for a month before it came right back to where I started. Is Jevtana that much better? What input are you getting from patients?

[Tall_Allen in reply to Buzy1]

Anecdotes from other patients are pretty much worthless, whether you've heard them or not. The following trial represents the experience of 378 men who took cabazitaxel vs 377 men who used a placebo after Taxotere failed. Mortality was 30% higher in the placebo group. You may have never heard from any of those patients, yet someone did.

thelancet.com/article/S0140...

[MyWifeMyLife in reply to Tall_Allen]

Hi there, my Doc wants me to start taking a combo chemo therapy for APC and extensive bone mets. It’s Carboplatin and Jevtana together for 6 rounds every 3 weeks. I cannot find any phase III data at all from MD Anderson (Houston), that completed limited phase I and II. I’m very concerned if I’m on the right track? PSA=258 Alk. PHOS= 600s, no not good! I’m also on Lupron every 3 months..the combo includes prednisone once a day and I have cardiovascular disease (high mostly controlled b/p and Cardio artery calcifications) so that too concerns me. Have you or anyone here been on the combo therapy? Any feedback would be greatly appreciated!

[Tall_Allen in reply to MyWifeMyLife]

They are doing a Phase 3 trial. Phase 2 results look very good for the combination.

pubmed.ncbi.nlm.nih.gov/315...

[MyWifeMyLife in reply to Tall_Allen]

Thank you for this Link! Take good care.

[MyWifeMyLife in reply to Tall_Allen]

Thanks, yes I had already found the Phase I AND II trials..I just cannot find the phase III trial yet? I’m just learning this is what my Doctor is starting me on This Tuesday. He never mentioned it was a clinical trial (?). And not FDA approved yet. Somewhat worried me..if I could see the phase 3 trial set up, it would greatly help.

Thanks if you know where?

[Tall_Allen in reply to MyWifeMyLife]

They are still doing the Phase 2 trials. your oncologist doesn't have to give it as part of a clinical trial because both drugs are already approved. He only has to have an hospital-approved protocol.

clinicaltrials.gov/ct2/show...

clinicaltrials.gov/ct2/show...

[MyWifeMyLife in reply to Tall_Allen]

Yes, that’s true. Thanks for your help on this.

[MyWifeMyLife in reply to Tall_Allen]

And the links too! It’s going to be a long road but I shall prosper!

[Finlay66 in reply to Tall_Allen]

I'm wondering what the result of this was? I did suggest the Carboplatin combination to my consultant but he seemed to suggest it worked best with BRCA patients.

[Tall_Allen in reply to Finlay66]

Results next year.

[Hidden]

Only you can decide if it is worth it to get treatment. You feel good and have no pain which is a true blessing. My husband's oncologist says "[late stage] chemo will make you feel good if you feel bad, and make you feel bad if you feel good." The 2010 study quoted above compared an old treatment with cabazitaxel and there was only a 3 month survival benefit but an 82% chance of grade 3 or higher neutropenia. Personally I don't think it's a slam dunk at all to go with treatment, especially with your current pain free, feel good status. Good luck with your difficult decision.

[Buzy1 in reply to Hidden]

Thank you for your comments

[Hidden in reply to Hidden]

My doctor told me that the dose given with Cabazitaxel was too high initially, but they lowered it and were able to reduce the myelosuppressive effects significantly.

I believe the trial you were referring to was the TROPIC trial. In the TROPIC trial, febrile Neutropenia was 6.7%. Neutropenia was 4.85%. You can see the results for yourself. Here's a link:

clinicaltrials.gov/ct2/show...

It's best to look at trials involving many people as opposed to the non-scientific anectdotal stories.

[abmicro]

This chemo is a rough road but works better than taxotere. PSA went from 40 to 4 after 3 infusions. Pain a little better.

Lots of nausea, low red counts, fatigue, diarrhea starting 6 days after infusion lasting a week . Had to cut my dose a little to tolerate. I am doing it with Neulasta to keep my white counts up.

[Buzy1]

Thank you for your comment

[Saydeebugz]

My husband has been in remission for 1yr now. He also had bone mets, treatment included 10 rounds of Jevtana w/minimal side effects (no hair loss, no nerve damage, some fatigue, mild stomach upset). Treatment also included Lupron shot every 3 months, daily Zytiga, then 6 rounds of Raduim 223. He is now a 2 time survivor... wishing you luck ♡

[Buzy1 in reply to Saydeebugz]

Thank you for responding

[MyWifeMyLife in reply to Saydeebugz]

Thank you for sharing.

[Coopertino]

Is your husband in remission but still has bone Mets? Do bone Mets go away?

[Saydeebugz in reply to Coopertino]

No more bone mets. Had check w/oncologist June 30, still clean!!