Bone marrow suppression with cabazitaxel carboplatin combination

[Javelin18]

I see a number of members are receiving combination treatment of cabazitaxel and carboplatin. I'm wondering how that affects bone marrow suppression. Please comment on your experience with red and white blood counts while receiving the treatment

[Hidden]

From what I know, the problem is Cabazitaxel. Patients who get Cabazitaxel often need Neulasta.

More inofrmation from a clnical trial:

ncbi.nlm.nih.gov/pmc/articl...

Neutropenia (all grades) occurred in 94% and 88% of the cabazitaxel and mitoxantrone groups, respectively. The most common grade 3 and grade 4 hematological adverse events are listed in Table 1. Grade 3 or 4 febrile neutropenia occurred in 8% of the cabazitaxel patients and in 1% of the mitoxantrone patients.

[Javelin18 in reply to Hidden]

Thanks. I think all chemotherapy causes bone marrow suppression. I'm guessing it might be worse with combined treatments.

[Hidden in reply to Javelin18]

Cabazitaxel is worse than Docetaxel when it comes to bone marrow suppression.

[Hidden in reply to Javelin18]

Yes. We just finished cabazitaxel and had to go on Neulasta when white blood cell counts dropped to 1.6. He only needed it for the last three treatments. But it got low even in the beginning. Just not that low. Neulasta handled it well.

[HopingForTheBest1]

As part of my chemo combo treatment I am getting Neulasta to boost my white blood cell count; very effective.

[Javelin18 in reply to HopingForTheBest1]

I'm getting neulasta with my cabazitaxel treatments. How is your hemoglobin? Mine dropped to 7.8 after my first cabazitaxel treatment, which followed the Lu PSMA treatments.

With that experience, I think I probably wouldn't tolerate the combined treatment well

[HopingForTheBest1 in reply to Javelin18]

Hemoglobin no change at 10.4

[Javelin18 in reply to HopingForTheBest1]

Very nice

[CAMPSOUPS in reply to Javelin18]

Good question. The replies regarding WBC I think WBC depletion is a given practically. I guess a question would be is it worse with the chemo combo?HCT, RBC, etc. is affected by Taxotere how much more with the combo ?

I guess I just repeated your question.

I had the 6 infusions of Taxotere and Neulasta was mandatory even then my WBC counts were low. My HCT, RBC and other marrow related markers were low. Quite low. Then again I went into the treatment with extensive body wide bone metastasis so marrow was already affected I would imagine.

Finished chemo 2 years ago. Started Zytiga 9 months ago. Monday's blood test and some of my blood markers are still out of range but I have been on Zytiga for about 9 months and I "think" it can be side effect of Zytiga--or the met damage already done 2 -1/4 years ago.

WBC--7.0 L/uL (normal 3.0 to 8.9)

RBC---4.36 M/uL (just within normal 4.2 to 5.6)

HCT---38.9% (39 to 49 normal)

MPV---9.4 fL (9.5 to 13.4 normal)

HGB---13.2 g/dL ( 12.5 to 16.6 normal)

[Javelin18]

Thanks for the replies. From this small sample, it looks like I'm affected more strongly than others. I think the cabazitaxel alone will hold things at bay, whileI wait for the CAR -T trial to start.

I won't think about carboplatin for now.

[CAMPSOUPS]

One infusion at a time. If the blood markers look good after 3 infusions sneak in a reduced dose of carboplatin ? lol maybe.

[dockam]

I'm five Cabazitazel sessions in and so far the numbers look fine

Having #6 Cabazitazel right now and PSA at 2.7 down from 3.1 ,three weeks ago

Fight On y'all

Randy

My labs from 03/10/22

[Javelin18]

Glad to hear it. Your numbers look great.

[leebeth]

My husband has had 3 carbazitaxel/carboplatin infusions. His Hgb is consistently around 10, no matter where he is in the cycle. It was around 12 prior to beginning these rounds. He had 6 rounds of docetaxel last year, and that never had an effect on Hgb. He is on Neulasta to support WBCs this time. He did not need it with docetaxel. His WBC drops to around 1.0 at one week post infusion, but rebounds to normal by next dose.

His platelets have stayed WNL, with a minimal dip to 117,000 one week after his third cycle.

[Javelin18 in reply to leebeth]

Sounds like he didn't have any bone marrow suppression. Glad to hear he did so well. I'm always surprised by the wide range of responses to treatment.

[XrayDir]

I was on Cabazitaxel-Carboplatin combo with Neulasta for only two cycles. I became extremely dehydrated and had to have saline infusions every other day. I was extremely fatigued and also had to have blood transfusions. So I have stopped the treatment and I am now waiting for a clinical trial with Dr. Luke in Omaha.

[Javelin18 in reply to XrayDir]

Thanks for sharing your experience. Sounds like you recovered from some bad effects. I hope your trial starts soon and you get good results. My trial is delayed a couple months, so trying to manage my cancer and general strength until it starts.

I see the chemotherapy as a step toward the trial, rather than hoping for it to lead to remission. With that in mind I'm not wanting to be too aggressive with it.

[kaptank]

Just a small matter for information. It is looking like those with BRCA mutations do better on carboplatin than those without. Often with cabazitaxel. That is a discussion I have to have with my onco in the future..

[Javelin18 in reply to kaptank]

Thanks for that information. Hadn't heard that before.