Questions on Jevtana

Hi folks, Xtandi was putting the brakes on Pat’s PC, but his PSA was still rising. So now his oncologist is moving him on to Jevtana.

I have a couple of Jevtana related questions. His doctor put him on 20 mg every two weeks, which seems fine. But he is leaving him on a half dose of Xtandi. Has anyone else stayed on Xtandi when they started Jevtana? Also, he’s not giving him prednisone, which I thought was always given with Jevtana. Dr. feels it’s not necessary. Any thoughts on that? Thank you in advance for any help.

[tango65]

Info about Jevtana from the FDA:

accessdata.fda.gov/drugsatf...

[Hidden in reply to tango65]

Thank you!!!

[tango65 in reply to Hidden]

Best of luck!!

[Tall_Allen]

Does the MO feel that prednisone is not needed with the lower dose? It usually prevents the worst side effects of chemo.

The combo of docetaxel+Xtandi delayed progression more than docetaxel alone, but did not extend survival:

ascopubs.org/doi/10.1200/JC...

[Hidden in reply to Tall_Allen]

He said he does the lower dose more often and it works better. On the prednisone, he said it was old research that said you needed it but it’s not true. I just don’t know what to make of it. I guess we can try it his way and if the side effects are too bad I can always insist on the prednisone and 3 week increments. He’s a highly recommended oncologist, but not very communicative. I’ve been pushing harder now that were at the end of standard of care. I’m just worried because the Lynparza left him bedridden and we’re just getting him back on his feet again. I don’t want him going down again with too harsh of a treatment but we also know his cancer is active again.

[Hidden]

Here's the information for the PROSELICA trial where they proved that Jevtana at 20mg/M2 is not inferior to a dose of 25mg/M2.

jevtanapro.com/studydesignp...

Jevtana at a dose of 20mg/M2 is taken in 3 week cycles with Prednisone so I would question why your doctor wants to do it every 2 weeks without Prednisone. That is not how it is normally prescribed.

ascopost.com/issues/decembe...

On September 14, 2017, the microtubule inhibitor cabazitaxel (Jevtana) was approved at the lower dose of 20 mg/m2 every 3 weeks in combination with prednisone for treatment of patients with metastatic castration-resistant prostate cancer...

[Hidden in reply to Hidden]

Thank you so much for this information. It’s better to go in armed with solid background.

[HerbieP in reply to Hidden]

I'm not taking prednisone with Jetvana though I did take it with Taxotere - my MO says it's not needed with Jetvana as they give me dexamethasone with the infusion. My side effects on Jetvana so far are much less than they were with Taxotere, I get my 4th infusion this coming Tuesday.

[Hidden in reply to HerbieP]

Thank you for this information. He’s been concerned because taxotere was rough. Really hoping this is better tolerated.

[Hidden in reply to Hidden]

I think there is flexibility with the Prednisone. When I did Taxotere, I took Prednsisone more or less "as needed" I was not given Dexamethesone as a pre-med so the first week was pretty rough. Prednisone made the side effects so much more tolerable, but I usually stopped it after the first week.

Many find Jevtana to have less side effects than Taxtere so you can probably just see how it goes.

[Hidden in reply to Hidden]

That’s where we’re at. But I want to know my options if he does have problems with it. Thank you so much for your help.