Any experience cabazitaxel (Jevtana)without prednisone? Referencing preliminary report published Aug 2017.

[Barbara345]

This is much of interest to us, as husband Barry just started cabazitaxel with prednisone; we’re concerned about short and long-term effects of prednisone.

A preliminary report published in Journal of Cancer, August 2017, entitled ““Influence of Prednisone on the Efficacy of Cabazitaxel in Men with Metastatic Castration-Resistant Prostate Cancer” studied 91 patients in Italy and showed median survival 9 months with prednisone and 14 months without it, without negative effects on safety. One of the authors is listed at the University of Alabama, Birmingham AL; the others are in Italy.

Link to the abstract is at

ncbi.nlm.nih.gov/pubmed/289...

The full text of the report can be downloaded or read from

jcancer.org/v08p2663.htm or

researchgate.net/publicatio...

As background, I read that docetaxel, also a taxane, was originally used with prednisone, and that the CHARTEED trial proved docetaxel worked as well without prednisone. I wonder if this was the impetus for the work concerning Cabazitaxel.

[Tall_Allen]

I think he will feel better with it than without it.

"Prednisone and other corticosteroids are used frequently in the treatment of advanced prostate cancer. Corticosteroids are sometimes prescribed to alleviate pain from bone metastases, for management of cancer-related fatigue, or to potentially reduce chemotherapy-related toxicity. Beyond these palliative uses, corticosteroids have also been associated with favorable antitumor responses."

It may not add to survival if he used prednisone previously because of prednisone resistance.

"The incorporation of prednisone potentially augments the efficacy of docetaxel in patients with mCRPC. We hypothesize that this advantage is limited to patients who have not previously received corticosteroids. Prospective confirmation is needed."

nature.com/articles/pcan201553

[Barbara345 in reply to Tall_Allen]

Thanks for the response and the links. I'm interested in all info concerning this.

[Tall_Allen in reply to Barbara345]

I've never run across an oncologist who didn't prescribe it along with chemo. But I can see why you might be wary of reduced immunity during the pandemic. Neulasta is a good precaution. On the other side of the argument, if he does contract covid-19, he will be given prednisone anyway.

[Fairwind]

After Doce failed, Jevtana gave me another year..It also had fewer side effects.. I'm not sure if I was on Pred or not I think I was..Yes I was.. A low dose, 10mg once a day.. With everything else going on, the Pred was not an issue one way or the other..There are other steroids that deliver a noticeable boost...Much more powerful than Pred..

[Barbara345 in reply to Fairwind]

Thank you. Did the Jevtana stop working? What are you taking or using now? I'm trying to learn all I can. Barry started Jevtana after docetaxel failed and then Xtandi failed. If this fails I'm trying to be a little ahead on options. We're also waiting for the results of the Foundation One testing,

For the record, so far Barry is having no noticeable side effects from the Jevtana or the Neulasta he got with it. Hopefully that will stay the case.....

[Hidden]

I can only offer this. During a six month clinical trial, part of the regimen was 30 mg (20mg in morning and 10 mg in evening) of Prednisone for 180 days. Why? This drug, according to my researcher medical oncologist, has cancer cell killing properties. This was in 2004. The main side effect was that I gained 80 pounds during the six months. Very hard to take off the extra pounds.

I believe that this is the major reason why today the dosage is 5 to 10 mg. For me, as one who had metastatic prostate cancer and eight others in the trial who had a complete response, it proved to be a cure. I understand that today, the reason that Prednisone is given in low dosages, is that the drug helps to ease the effects of chemo. Some question, at what price? As I sit almost sixteen years later, I would most definitely do it again.

My treatment was nothing like the standard of care today only because it did not produce the same results across a side spectrum of disease. It worked under very limited conditions of newly diagnosed metastatic prostate cancer.

My thought process when I enrolled in the trial was strictly to kill as many as the little bastards that I could; regardless of side effects. At the time, all of the stats told me that I had two to four, maybe five years to live. Since then new improved silver buckets have been developed and tested to change those initial forecasted numbers tremendously so that it may not be necessary to poison the body as much as I did,,... so that men caught early on with metastatic disease have a prognosis of dying from something else rather than their disease. Palliative or controlled treatment is the watchword of “do no harm”.

I can not advise what is best for your husband other than listen to his experienced prostate cancer specific medical oncologist.

For anyone, especially those who have never had to deal with the ravishes of metastatic disease, to say my case is antidotal, I say, I have been without any cancer treatment since February 2010, whether it was the clinical trial or the hand of my Creator, I’ll take it. At, 73 years of age, I am enjoying life and trying to give hope to others. Stay positive and kill as many of the little bastards that you can, then enjoy life.

Gourd Dancer

[Curehunter in reply to Hidden]

Very pleased for you and may you enjoy many more years of good health. Were you on any special diet or used supplements? I'm just starting out on my APC journey.

[Hidden in reply to Curehunter]

I have never taken supplements until COVID. In fact, my medical oncologist emphasized no supplements unless he approved first as he did not want them messing up with his research. However, he did prescribe high doses of Vitamin C during the trial as a part of his study and treatment. But it is not something that I would go buy over the counter in any regard. Everybody is different in degree or scope of disease, if one chooses to add supplements, which could mask test results, please inform your medical oncologist.

Gourd Dancer

[Curehunter in reply to Hidden]

Thanks, that's useful to know

[Barbara345 in reply to Hidden]

Happy for you too!