Is Xofigo a good option for extensive skeletal mets?

[Pianodude]

I finished my Docetaxel treatments after five of six rounds. They decided against the last one because of increasing numbness in my feet. I am still on Firmagon. My bone scan done last week showed a slight improvement in a couple of bones, but overall, not much change. At least there was no increase. My PSA is 0.6 down from 869 in late May. Alkaline Phosphatase is in the normal range after being in the 300s. What about Xofigo as a next step? My MO did not mention it and just wants to keep me on Firmagon and see how things go. Any thoughts?

[Tall_Allen]

Xofigo, like most therapies, works best if done sooner rather than later. However, it only works when there is active bone remodeling going on, so you may want to wait for some evidence of renewed activity. NaF PET scan, if you can still get it, is particularly good for monitoring bone remodeling.

Xofigo seems to combine well with docetaxel, even at a lower dose:

ejcancer.com/article/S0959-...

It also combines well with Provenge.

[Pianodude in reply to Tall_Allen]

Thank you.

[tango65]

Xofigo was approved for symptomatic bone metastases in metastatic castration resistant cancer without visceral metastases. If your metastases are not causing trouble (the alkaline phosphatase is normal) and you do not have pain you could consider to ask for Provenge at this time and discuss having Xofigo if your alkaline phophatase starts going up or there are skeletal related events (pain , etc). If you are not treated with bone agents such as xgeva (denosumab) or zoledronic acid you need to talk with your MO about these drugs.

[Pianodude in reply to tango65]

Thank you. I am not having any major pain and I am not castrate resistant, so I guess that would not be the next step.

[tango65 in reply to Pianodude]

Best of luck on your journey.

[Pianodude in reply to tango65]

Thank you.

[Cheerr]

Hi, your profile seems similar to my dads. You can check our Bio. Has your doctor mentioned about Zytiga?

Usually Zytiga is next preferred if PSA / ALP etc start rising post chemo. If you don’t mind what’s your age?

[Pianodude in reply to Cheerr]

I am 62. My doctor has not mentioned that. He did mention Provenge.

[Fairwind]

Dosezetaxel similar to Dosetaxel, and also called Jevtana worked better for me with fewer side-effects..No foot problems with it..If your mets are confined to your bones, then R-223 (XOFIGO) should be considered..Talk with a Radiation Oncologist about it..Medical Oncologists (MO's) tend to be shy about most radiation treatments..