Cabazitaxel Plus Enzalutamide

[EdBacon]

Wondering if anyone here has had this combo prescribed and what the results were.

There was a phase 1 and phase 2 trial that proved the safety of this combination and they also saw a PSA response 30% or more in 30% of the patients who had previously been treated with Abiraterone. The patients that had not been treated with Abiraterone had a much better PSA response as would be expected.

Here's some info on the phase 2 trial if anyone is interested.

ascopubs.org/doi/abs/10.120...

[CAMPSOUPS]

Ed no "takers" on your question.

I am also interested. The potential "re-sensitizing" with either chemo (dox or cab) after Zytiga fails is of interest. My slow brain has understood this to be the case especially with Dox causing Enza to be of benefit. Not sure about Cab.

[EdBacon in reply to CAMPSOUPS]

Oh there are plenty of takers on this forum.

[CAMPSOUPS in reply to EdBacon]

Not sure what that means and hope I dont regret not leaving it alone lol.

[EdBacon in reply to CAMPSOUPS]

It's amazing how there is no interest here for this post, something that I would think should be of interest to many with CRPC, yet there have been 34 responses so far to a post about chlorine dioxide. Makes me wonder what I'm doing here.

[CAMPSOUPS in reply to EdBacon]

I'm with ya. This is one of the first cross roads us advanced guys come to after initial treatment (Xtandi, or Zytiga, or Chemo + Zytiga, etc.) stops doing the trick. I knew it was coming for me eventually that the nice ride on Zytiga after my initial Docetaxel treatment wore off would come to an end.

And here I am. Zytiga no longer viable. Doing what I thought best but some reassurance would be nice. I am on Docetaxel again ( one infusion in the tank) after having had it at diagnosis 3 years ago. Would be nice to see input on comparison of same mind set but using Cabitaxel instead.

I will say Allen's post today on Enzalutamide + Cabitaxel looks promising.

Oh god. Sodium Chloride. Yea I can think of other kill the host methods as well. Ace Hardware sells Acetone buy the gallon. That should do it.

VERY SCIENTIFIC

[EdBacon in reply to CAMPSOUPS]

I also saw TA's post today and it kind of fits in with where I'm at right now. We have proof in the CARD trial that going to chemo before switching advanced anti-androgens is more effective. TA's post about Docetaxel extending the effectiveness of Xtandi is just a diiferent angle on the same thing. I think the problem is that our doctors have us stop the anti-androgen before going on chemotherapy and we should be continuing it IMO because we are likely dealing with different populations of cancer that respond to each treatment. We shouldn't assume that Xtandi is not working because resistant variants have emerged. We don't stop ADT when we take chemotherapy.

Since it's already been proven in phase 2 trials that either Xtandi or Zytiga is safe to take with chemotherapy, I would think we'd want to do both chemo and Zytiga or Xtandi, probably the opposite of what we've used already. I am. I figure hell with it, it's my life and if there is a low risk, why not try?

[CAMPSOUPS in reply to EdBacon]

Therz a lot of things guys do on their own here that I wish they wouldn't.

But considering the trial posted by TA and considering Xtandi is a mode of ADT as you pointed out (we continue lupron etc during chemo) I too don't see any harm in trying it with your chemo. I think the trials look for least SE's which you may see increased fatigue of course and maybe some other SE's but again your not reinventing the wheel as it were by adding it to chemo.

On the devil's' advocate side just mouthing the word selectivity conjures up a conundrum of science that is way over my head. Wait for the ones unselected and which will mutate into unselected by chemo then hit with Xtandi? I just don't have the answer.

Another consideration is unless a trial is looking at combo effects it always is necessary in the trials to have a wash out of the previously used drugs to isolate the ones in the trials. It isnt always a matter of the combo wont work but that the trial needs to isolate one to see its effects.