Rising PSA after 7th infusion of Jevtana (Cabazitaxel)

[Howmuchisthefish]

Hi guys, I'm just wondering if anyone else was in a similar boat or could share any knowledge?

So my dads psa has declined every cycle since he started Jevtana in August. He started with over 700 and it slowly went down every cycle all the way to 161 on 07/12/2020. Latest blood test was on the 5th of January and the PSA went up to 181. He had an extra week off chemo for that cycle.

So I'm just wondering what this means if anything. It's still quite a high psa and honestly I was hoping for at least a couple to a few months of stable disease for him after he finishes chemo. But only after one week off it seems like it the psa just took off. Which is worrying to say the least. Last week he had his 8th infusion and then he has 2 more.

Another worry I have is I think I was overly optimistic about him being able to participate in clinical trials after the chemo. From looking at a number of clinical trials it looks like at his stage the trials become very difficult to get into even if bloods are satisfactory.

Some backround... Dx in Dec 2016 with psa of PSA of 3951. Had early docetaxel chemo and then abi and some trial drugs. Had a test to look for genetic mutations a few months ago, none found.

[Tall_Allen]

Can he add carboplatin for the next infusion? If he has bone metastases,it may be good time to start Xofigo too, like in the following study:ejcancer.com/article/S0959-...

Consider Provenge as well.

[Howmuchisthefish in reply to Tall_Allen]

I forgot about the carboplatin thank you for reminding me. I'm going to ask his oncologist about it. I remember he mentioned it before he started chemo so perhaps he would agree to add it for the final 2 infusions. I asked him before about Xofigo, but they wouldn't do both at once here and it's administered at another hospital as well unfortunately. Provenge hasn't been approved for MCRPC here, at least on the NHS because of the cost. Just have to hope that a promising clinical trial comes up and he will be eligible after he finishes chemotherapy. The options are definitely becoming limited now.

Thanks for the reply and ideas Tall Allen.