Low dose cabazitazel for bone marrow infiltration

[Luv2fish]

Hubby has advanced stage 4 PC. Casodex, lupron, taxotere, Zytiga, Xtandi, Keytruda, cabazitazel + carboplatin, xofigo (1 dose). Adenocarcinoma and neuroendocrine. PC now in his bone marrow. Trying low dose cabazitazel. Anyone done the same? He so tired.

[Tall_Allen]

One patient I know had some success with an older kind of chemo called Mitoxandrone. He said he felt much better on it than taxanes. It is purely palliative.

[JLS1]

That may not be the best chemo to try, even at low doses, per this:

nccn.org/patients/guideline...

"Cabazitaxel Cabazitaxel is an option if docetaxel doesn’t work. However, the benefits of cabazitaxel are small and the side effects can be severe. You should not take cabazitaxel if your liver, kidneys, or bone marrow is not working well or if you have severe neuropathy, a nerve problem that causespain, numbness, and tingling that starts in the hands and feet. "

It was the one treatment that my poor husband did no tolerate well at all about 2 years ago. His blood counts plummeted. However, that was also right after he had RT to his lower spine, so a double whammy

[Luv2fish in reply to JLS1]

Hubby did 9 of cabazitaxel and carboplatin in 2018 and 6 more in 2019 and tolerated it very well and had great response both times. Our oncologist at UCSF says there’s a 30-40% chance this will work so we shall see. He gets his blood drawn twice a week to stay on top of it.

[JLS1 in reply to Luv2fish]

That sounds VERY encouraging! I'm SO glad your oncologist is giving you hope! Wish I knew about this - maybe could have helped my husband. Our MO, being too clinical, just threw in the towel on him - took away his hope, until I did further research to show there was still PLENTY of reason for hope! You and your husband are in my prayers.

[JLS1 in reply to Luv2fish]

Do you mind if I ask what your husband's RBC, hemoglobin and platelets are? Were his platelets really down to 9? If so, did he get a platelet transfusion?

I'm still upset, thinking of all the things that might have helped him if only ...... our MO couldn't find any spreading in his CT scans or MRI reports, so he assumed the PSA rise, to the mid 30's (after his 4th Xofigo injection) , was all in his bone marrow, so he abruptly threw in the towel - said there was nothing more he could do. I started researching 24/7 and found Proxalutamide was working well for patients similar to my husband. I tried to get him into the Proxalutamide trial, with the help of a wonderful oncologist in SC, but he got excluded due to the one shot of Jevtana/Carboplatin chemo...then MO said Darolutamide (which he was able to get asap) is almost exactly the same. So we gave it a try. His PSA started to go down...after he started Darolutamide.

[Luv2fish in reply to JLS1]

Hemoglobin 9.4, after I unit of blood on Saturday

Platelets 9 (he had a platelet transfusion today before his 2nd low dose cabazitazel)

RBC 3.07

Blood work again on Friday.

[JLS1 in reply to Luv2fish]

Thank you. Very interesting. Please keep us posted how he does on the chemo. Keeping you and your husband in my prayers....

[JLS1 in reply to Luv2fish]

Do you mind if I ask who your MO is at UCSF?

[Luv2fish in reply to JLS1]

We have a local oncologist in Auburn, CA. Our UCSF oncologist is Dr Rahul Aggarwal. He’s amazing.

[JLS1 in reply to Luv2fish]

You're very fortunate he's willing go to outside of the box. I feel strongly if we were able to find an oncologist like that, my husband would be doing well today. I think due to hospital protocol, and insurance companies, fear of potential liability, etc.. that too many oncologists just won't (or can't) go outside the SOC box. We tried seeing other oncologists in our area, but it seemed they didn't want to step on our oncologist's toes - probably because he's so well known. Wish we would have found a good integrative med Dr. back when my husband was diagnosed, because there are so many other things you can do to help slow the cancer and make treatments work better. So many of these things I learned here on this board, but too late. -and many of these things our MO said yes, that can help....so why the heck didn't he tell us this in the beginning!!!!! Also, NO help navigating clinical trials.

[Green_Guy]

Sorry about your husband. So you are in Auburn...that's close to good fishing territory, that's for sure.

[Luv2fish in reply to Green_Guy]

Grass Valley … for about another month. Moving to Michigan.

[Green_Guy in reply to Luv2fish]

Grass Valley. Never been there, but I think it's a good place for retirees. My first job was with a semiconductor company in Orange County. We had a design center in Grass Valley, and I heard that people would go out after work to pan for gold. Have fun in Michigan. At least you won't be moving there in the winter.