Having my last infusion of Provenge today. Just finished appointment with MO. He talked about docetaxel. He said when I start that, I will get an infusion every 3 weeks until it stops working. This is different than what I expected. I thought it was usually 6 infusions then done ???
Also blood work showed no gene mutations but they will send sample of my prostrate biopsy from 2+ years ago for genetic testing. ?
There are 2 different protocols for Docetaxel. Those who take it at diagnosis while still hormone sensitive usually get 6 cycles based on trials that were done (CHAARTED and STAMPEDE).
Once you become castrate resistant, the protocol is to take it as long as keeps working and the patient can tolerate it. If it becomes ineffective, the patient can move to second-line Cabazitaxel.
If the patient has already had early Docetaxel, but it was not considered effective, then the doctor will not rechallenge it after castrate resistance. Instead, Cabazitaxel will be used.
Thanks
Mayo showed 6 cycles when I researched them 3 yrs ago, but may have changed since then. I chose non-Mayo clinic and went 9 cycles.
Were you castrate resistant when you started Docetaxel? Your profile said something about you having to fight for 9 cycles?
Dr didn't want 9 cycles. Wanted to stop after 8 and he was probably right. Side effects after 8 weren't to bad yet. Suspected cr might be present acct rising PSA during Docetaxel after cycle 4. Added Xtandi. Present MO says not cr acct Xtandi holding PSA below 0.13 but who really knows when taking second line of defence drug currently.
Ask your MO why? You deserve and have the right to an answer before you begin Docetaxel infusions. If you don't agree with his response, get a second opinion and don't get a second opinion here.
For metastatic PCa, original prostate biospy tissue is not adequate for genetic screening for somatic muations. You want a tissue sample of metastases if possible..
6 weeks is the standard protocol for patients with mCRPC, but that can be extended if it is working well and side effects are tolerable.
Have you had Xofigo yet? It seems to combine well with either Provenge or docetaxel. Maybe send these links to your MO and discuss with him:
ejcancer.com/article/S0959-...
ascopubs.org/doi/abs/10.120...
In many cases, Xofigo can be repeated.
Lots of things I don't know. Being able to repeat Xofigo was one of them. I've seen several here state that Lu 177 can't be used after Xofigo has already been used. I'ts one or the other. Do you have any knowledge or opinion on that subject?
The clinical trials in the US of Lu-177-PSMA exclude patients who have used Xofigo. That doesn't mean it can't be used. It just means that they want a clean reading for the purposes of the clinical trial. Probably, they wouldn't care in Germany.
There has never been a randomized trial of one or the other. But for a man with symptomatic bone metastases and no visceral metastases, I would certainly recommend Xofigo because it is widely available and he can get it now.
I ended up with 8 cycles. They changed from 8 to 6 and then back to 8 again. It looks like they were thinking of 10. I think they need to look at your response and also how you handle the side effects. I was and am hormone sensitive.
So the more I read the more I’m thinking the reason MO says to take docetaxel until it stops working instead of “ 6 rounds “ is because it most likely won’t work for 6 cycles. Is that right?
Docetaxel
Docetaxel
