Folfox after Taxotere and Jevtana failed

[Lousab]

Reading your posts on the forum has been very helpful to understand my father's course of treatment.

My father was diagnosed in March 2018 : T2N + M0, PSA 10.9, gleason 4+4. He was 74.

He received hormone therapy (Anandron- Decapeptyl then Casodex-Decapeptyl) and radiotherapy and was cancer free for one year. Then, a PET scan showed a lesion on T3 and on the left sacro iliac joint. Moved on to Xtandi + Decapeptyl followed by Zytiga + Decapeptyl.

June 2020, still on Decapeptyl and Taxotere, 6 infusions. Break for a 3 months then second line chemo Jevtana. Stopped after 4 sessions of Jevtana. Oncologist says he is resistant to both Taxotere and Jevtana. PSA doubled between the last two rounds of Jevtana ( it never went down significantly before with either chemotherapies). Pet scan shows some progression of metastasis but my father remains asymptomatic. No bone pain for the moment.

Now, Dad is about to start a new chemotherapy, Folfox. I looked it up and see that it is normally used to treat colorectal cancer. Has anyone had experience with Folfox and prostate cancer? Or any idea why such a treatment is being considered?

Are we running out of options here?

My father is in Paris, France and I am translating from French.

Any insight would be appreciated.

[Tall_Allen]

Have they biopsied any of his metastases to see what kind of prostate cancer he has (histology, IHC and genomics)? Is Xofigo available in France?

tom67inMA uses folfiri for his neuroendocrine cancer:

healthunlocked.com/advanced...

[Lousab in reply to Tall_Allen]

I think Xofigo is available. I asked and was told it was not indicated when the prostrate and lymph nodes have not been removed because it works only on bones. I asked about genetic testing and my father just had a blood test that is supposed to identify the type of cancer. Results take 3 weeks. Thanks for the link to tom67inMA’s blog. It looks like there is hope but I am still concerned that folfox is a strange choice of treatment.

[Tall_Allen in reply to Lousab]

Xofigo is approved as long as the stage is M1b (bone metastasis). It is not approved when there are visceral metastases (M1c), but neither the original disease in the prostate nor lymph nodes count as "visceral metastases."

Let me know the results of the blood test. A tumor biopsy would tell you more.

[Lousab in reply to Tall_Allen]

Thank you Tall_Allen

[Harry_B]

Hello Lousab. My cancer progression is quite different to your father's and I don't think I can advise anything meaningful. Over the past 3 years of disease progression I have found Tall Allen's comments always thoughtful and his suggestions worth following. I wish your father well. Harry

[Lousab in reply to Harry_B]

Thank you Harry_B for taking the time to answer. I appreciate it very much.