We have completed 9 cycles of Cabazitaxel chemo, LD 05/08/21 (post-Abireterone ->Docetaxel(10 cycle)).
PSA->15 (1 Feb 21)->13.64 (#post 3 cycle, 5 April)->15.3 (#6 cycle, 14 June)->22.7 (#8 cycle, 2 Aug).
HB: 9.9, Also Found No feasible site for Biospy to check BRACA. My father tolerated the chemo well and stable now.
went for PSMA PET CT on 17th Aug:
In comparison to previous 68Ga PSMA PET-CT scan dated 15.12.2020:
Many of these lesions (in bilateral proximal humeri, right 3rd & 5th ribs, sacrum, bilateral pelvic bones and bilateral proximal femora) show increased tracer uptake (SUV max. of the reference lesions in right iliac bone & right femur are 22.8 & 11.4 respectively) – represent active metastatic disease. Rest of the skeletal lesions show no significant tracer uptake, suggesting healed metastases. [Increase in tracer uptake is seen in many of the skeletal lesions since previous study, previous SUV max. was 6.8]
Many of the skeletal metastases show significant interval increase in tracer uptake.
No interval new lesion noted.
Overall imaging features are suggestive of disease progression.
Our Dr. suggested below options:
Cabazitaxel+Enzalutamide (Phase II data)/ Enzalutamide/PSMA therapy with Enzalutamide.
We have to wait around 1 month for Lu177 psma therapy appointment if required, till the time being Dr. suggested to start Enzalutamide and meet with Nuclear Med doctors to check the eligibility (psma uptake ?) & time for Lu177
Kindly advice or share your thoughts on this?
PET/PSMA scan results after 3rd LU-177. Should I go ahead with SBRT or complete 4th LU-177?
PSMA scan results 
LOW PSA BUT CT SCAN PROGRESSION
PET PSMA scan and low PSA and Lurpon
Cabazitaxel update and variations of PSA
Sounds like a good plan!
Thanks, Allen for your response!
So we should stop cabazitaxel now and avoid starting (Cabazitaxel+ Enzalutamide)? and probably we should choose taking Enzalutamide now and add Lu177 psma therapy after a month and continue.
I was saying this plan sounds good: "Cabazitaxel+Enzalutamide (Phase II data)/ Enzalutamide/PSMA therapy with Enzalutamide." I understood that to mean you will continue with Cabazitaxel and enzalutamide (there are no new metastases). And continue with enzalutamide and add LuPSMA.
I agree, this is also looks a good plan.
But our both Dr.'s conflicting on using Cabazitaxel+ Enzalutamide together. Basically Dr. Amit Joshi at Tata Memorial, Mumbai is not in favour of using them together rather starting new treatment as Enzalutamide and add Lu PSMA.
So I am litte confused now and also wondering will Enzalutamide work as long as it used to, if used with Cabazitaxel together.