Has anyone taken Opdivo with Docetaxel?

[Avanat]

My husband, recently diagnosed with Stage IV metastatic prostate cancer, has been asked to participate in a clinical trial of Opdivo along with chemotherapy (Docetaxel) and is concerned about side effects.

[Avanat]

This is husband responding. I have taken a genetic spit test and will be be meeting with genetic counselor this week to cover test results which was for BRACA 1/2 and another 80 possible mutations. I have not had my tumor sequenced. Hopefully, the genetic test will determine PD-L1 marker. However, Opdivo is being administered along with Docetaxel as part of a clinic trial. My concern is with the use of Opdivo in conjunction with the Docetaxel and the potential AE and if the OS is increased enough to justify the risks. I’m 68 and in relatively good health but concerned my age may be a factor in tolerating this coupled treatment.

[Tall_Allen]

I think it is a good combination because the docetaxel can have the unwanted side effect of suppressing the immune system and the Opdivo prevents that. Hopefully, the Opdivo will thus prevent the worse side effect of docetaxel, and the docetaxel will dampen the worst side effect of Opdivo. Also the docetaxel kills a lot of cancer cells, releasing their antigens, and the Opdivo can maintain an immune response to the antigens.

[Stevana in reply to Tall_Allen]

Your response sounds scientifically reasonable. Please see my recent post to Nalacrats. Any additional feedback you may have is welcome.

[Tall_Allen in reply to Stevana]

People say all kinds of things in a forum. Some are worth considering, some not. That's why you have a doctor.

[Stevana]

Although I am not self-educated enough to fully follow all that your saying I tend to agree with you. The main reason for my question is because my oncologist wants me to enter a phase 2 medical trial (NCT04126070) that's studying the efficacy of Docetaxel + Opdivo on de novo mHSPC patients. I was diagnosed 10 weeks ago and accept that Docetaxel along with ADT is SOP for my type of case. I’m just concerned about adding Opdivo on top of the chemo and whether it’s wise at this point.

[Fuzzman77]

I am on Keytruda for two years next month. I am MSI-High with a partial MHL-1 MMR. Even though I was on APCEDEN vaccines off and on for 14 months the Keytruda kicked things into high gear making me feel the best I had in years. Even so, had to start Zytiga a month ago because PSA went up to .24. I did actually hit an undetectable PSA after my prostatectomy last September and was hoping I might be a miracle, but it has certainly given me extra good QOL for more than three years now. Still think immunotherapy combos hold promise for some of us. Keytruda is a PD-1 checkpoint inhibitor is why I shared with you. It does jack with my diabetes but that is all. No Lupron etc since January, 2016. Sounds like an interesting trial to me. I hope it helps you!!

[Bodysculpture]

I can speak for Docataxal just finishes my 6th and final infusion

Brought PSA down very well indeed

My side effects were limited

Hair loss

Fatigue

Tastelessness for a few days

8 days after chemo I am usually back to myself

One of the best of there for prostrate cancer in my opinion

[CG67]

My husband has been taking Opdivo since January and the MO just added Jevtana, which is often prescribed after Taxotere fails. For Bob at least, the Opdivo has had virtually no side effects. The MO says that the main concern with Opdivo is infection of organs (opdivo.com/about-opdivo/sid... and the MO checks his blood every week to be sure that all systems are working.

The main side effects that Bob has now are from the Jevtana (especially neuropathy). My hunch is that you're likely to feel the side effects of the Taxotere more than the Opdivo, My recommendation is to be sure that they test your blood frequently.

Good luck.

[Stevana]

I’m asymptotic but was diagnosed 10 weeks ago with with advanced metastatic PC with multiple Mets, Gleason score was 9 (4+5) with relatively low PSA of 3.8. I’ve had two infusions of Firmagon, but my doc wants to put me in the trial of Docetaxel + Opdivo. Doc says end result is to lower PSA to .07 or lower and to keep me on Opdivo once Docetaxel course is over.

[j-o-h-n]

You're new here... would you be kind enough to furnish us with your bio info? age? location? scores psa/gleason? treatment location(s)? doctor's name(s)? Thank you... All info is voluntary but it helps us help you and helps us too. Keep posting.... great info here....

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 06/10/2020 9:08 PM DST

[Avanat in reply to j-o-h-n]

My husband (Stevana) did put his information on his profile. I posted before he had set up a profile to post here himself. Thanks to all who post here as the information is incredibly helpful.

[Stevana in reply to j-o-h-n]

Hi j-o-h-n,

I assumed you could read my profile. Not sure how this works as many profiles only show someone’s name. In any event my profile info is below.

Retired 68 year old in relatively good health. Diagnosed with state IV metastatic prostate cancer upon initial biopsy in 3/2020. PSA was 3.8, but had doubled a month, later but is now 1.58 since beginning ADT. Have multiple mets in bones and lymph nodes. Currently asymptomatic. Have had two infusions of Firmagon. Beginning docetaxel treatment in a few weeks. My current main concern is fatigue, weight gain and loss of muscle mass. Gleason score 9 (4+5). All 12 samples on biopsy were positive- lowest score was 7, rest were 8s and 9s.

[j-o-h-n]

Thank you Avanat and Stevana for you quick and detailed reply. I did see your husbands bio on his home page. My Goodness he was just diagnosed. Well you've come to the right place for good information and comradery. There are so many new procedures and medications which will enable him to be around for a very very long time. Some of the side effects may be awful but he'll endure them.... we all do.... One of my side effects was my ex-wife but I just couldn't endure her.

BTW I don't know if you know that the name "Stevana" probably comes from the Greek name Stephana which means "crown". Stay well and keep us up to date by posting here.

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 06/10/2020 6:36 PM DST

[Stevana in reply to j-o-h-n]

Hey John,

My wife and I were finishing a good meal and looking at old posts and ran across this one from you. I just had my first round of chemo+nivolumab, as part of a clinic trial, and was moved to read your response from two months ago. Your words are encouraging and it helpful to know that there is a community of brothers, like you, who care and understand.

Warm regards,

From the Crown

[ctarleton]

Some historical information about such things in the controlled settings of prior Studies can be found in the Prescribing Information for Opdivo.

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