Jevtana + prednisone.

[cbgjr]

Do any of the local experts know anything about this SOC treatment?

I'm trying to find out what the purpose of prednisone is, in this case. I've seen reports that controlled studies show no improvement in OS taking or not taking it. Although my oncologist prescribed it, when i asked him, he wasn't sure himself... in fact he then said you really don’t have to take it if you don't want to (?).

steroids are immuno-suppressants of sorts, and have many other side effects, so I would rather not take prednisone unless it has some benefits. But I don't know enough to make a decision.

thanks for any info or leads. thanks.

CG

[cbgjr]

yes, but that may take some time. I just had second infusion and so far I'm taking the prednisone as SOC indicates. "Cabazitaxel is designed to kill cancer cells by decreasing their ability to divide into more cells. Prednisone is taken with cabazitaxel as part of the chemotherapy regimen to possibly slow the growth of cancer cells and reduce side effects from chemotherapy" .

But I'm confused about certain reports that prednisone does not increase OS or safety profile in this application.

for example:

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

CG

[pjoshea13]

"In the "TROPIC" Trial, cabazitaxel, administered concomitantly with prednisone 10 mg daily, showed a significant advantage vs. mitoxantrone in both Overall Survival (OS) and Progression Free Survival (PFS) / radiographic PFS in patients failing docetaxel-based chemotherapy. Similar to docetaxel, cabazitaxel has been approved in combination with daily prednisone, but the benefits of adding daily corticosteroids to taxane chemotherapy remain to be proven. In fact, corticosteroids have a variety of biological effects, and a number of studies in large cohorts of patients show that they may have both favourable effects, mediated by adrenal androgen and cytokine suppression, and detrimental effects related to their adverse events associated with their long-term use as well to the potential promiscuous activation of the AR. In fact, prednisone and dexamethasone can activate some AR variants that make tumors sensitive to glucocorticoids even at low concentrations. It has been showed that point mutations of the AR, which appear to cluster in the ligand-binding domain, are rare in therapy naive patients but occur in 15- 45% of patients with castration-resistant disease and can increase AR affinity for a wide range of steroids. On the other hand, insofar as safety is concerned, omitting daily corticosteroids does not seem to increase toxicity (e.g. hypersensitivity reactions). In fact, in the CHARTEED trial, docetaxel was safely administered without daily corticosteroids. Safety data about the use of cabazitaxel without daily prednisone/prednisone alone are missing.

"The CABACARE study is designed to assess the effects in terms of efficacy, safety as well as quality of life of omitting daily corticosteroids in patients treated with cabazitaxel."

clinicaltrials.gov/ct2/show...

-Patrick

[Hidden]

The dose of Prednisone is low so doesn't cause side effects.

I found the Prednisone made a huge difference in the side effects of Docetaxel so I would imagine it would also help with Jevtana. I tried to go without it and the side effects of chemo were much worse.

[Tall_Allen]

It counters some of the worst side effects of the chemo. It prevents inflammation, allergic reactions, nausea/vomiting, and increases appetite. It also has an anti-cancer effect of its own.

It is immunosuppressant, so it is especially a good idea now to also get Neulasta.

[Magnus1964]

You will not be given any larger dose than necessary and it is usually quite small.