Cabazitaxel Update

[Univs]

After a mixed response with Docetaxel (refer to my earlier post) I had my first infusion of Cabazitaxel two weeks ago. I have an initial follow-up with my MO tomorrow where I will, in part, put forward the possibilities/merits of “including” an Xtandi rechallenge i.e., as discussed earlier within the forum. My questions: How many cycles/weeks are needed to assess PSA response to Cabazitaxel ……is initial PSA flare something to expect? Truly Appreciate the Forum’s expertise and Experiences. Thank you!

[FormulaRob]

Hi there,

I see you are in Canada as well. Whereabouts? I am in Toronto and currently expected to be treated at credit valley hospital. My father has a PSA in the 200s as well with gleason 9 and is looking to start treatment. Wondering what your initial treatment was ?

Also since similar diagnosis.. wondering how positive your doctors are? they are telling my father 5 years but after reading and listening to many people here it seems like it is impossible to know as some people can go 10-15 years regardless. Mostly asking to see if we are in the best care or if we should find a new specialist in the area with a more optimistic approach on the long term survival

[Univs in reply to FormulaRob]

Hi. Residing in Ottawa. Refer to my profile regarding received treatments. I have found my Medical Team to be both supportive and responsive. Individual responses to differing Treatments various and is the Critical Factor. I have found this forum, through the advice and referenced experiences of its members, to be a great source of Positiveness and Hope!

[FormulaRob in reply to Univs]

Thats great to hear my friend, I wish you much success in this journey

[anony2020 in reply to FormulaRob]

Seems to depend on MDs practise and experience

[HopingForTheBest1 in reply to FormulaRob]

Absolutely true that there is no crystal ball that may tell how long we all have. Don't even dwell on it, and live each day one at a time. Keep in mind there have been many participants on this forum that passed, having fought this battle the best they could. A good number of which never reached the 5 year survival mark.

We all hope for the best.

[FormulaRob in reply to HopingForTheBest1]

Hey there my friend, your initial situation in 2018 looks similar to what my father just received in news. I read your whole bio and unless I just don't recognize some of the treatment names.. it seems like you did not do any radiaiton? They are about to start my father on 8 weeks straight 5 days a week for radiation

[HopingForTheBest1 in reply to FormulaRob]

I recently had 5 rounds of radiation on a specific painful spot on the left side of my back.

[Tall_Allen]

There is little harm in adding Xtandi to all future cabazitaxel infusions and possibly a benefit. The serious possible side effects are mostly due to chemo, not Xtandi:

prostatecancer.news/2022/10...

[Univs in reply to Tall_Allen]

Thank you very much Tall Allen!

[Fredjen in reply to Tall_Allen]

Hi Allen, prostatecancernews is speaking of docetaxel and xtandi, will xtandi be working with cabazitaxel too?

[Tall_Allen in reply to Fredjen]

I don’t see why not.

[EdBacon in reply to Fredjen]

I had a positive response taking Xtandi during Cabazitxel cycles. I have a significant amount of hip pain. It would go down to almost nothing after the Cab infusion, but start to return before the next. I started taking Xtandi when the pain returned and it went back down to nothing again. Also my PSA stopped going up when I added Xtandi.

[spw1]

My husband did not at all respond to Docetaxel and still was given 4 infusions. The SOC follows a flowchart. There was no way that doubling PSA was caused by a flare. Then Cabazitaxel started - symptoms worsened and PSA kept doubling. After two infusions and a bone scan showing progression, they stopped. PSA pre chemo 99 and at the end of 6 infusions as described, doubled between each. Currently over 1300. A Flare would be a rise in PSA by 10-15%. All factors together matter of course.

[Univs in reply to spw1]

Thank you for your response. Wishing you the Best.

[Leader4077 in reply to spw1]

VERY unusual that Docetaxel and the Cabitaxel(sp)would cause PSA to rise to 1300. I assume some form of ADT was given concurrently and testing for neuroendocrine PCa was done to rule out that.

If PSMA scans were done and showed progression a 1300 PSA showing bone Mets would be expected……….did the MO say he had bone Mets?

Mike

[spw1 in reply to Leader4077]

Bone mets were in the pelvis at diagnosis two years ago but had resolved on one side completely with ADT and Enzalutamide. When PSA started to rise again, chemo was tried. The chemo did not cause the rise so much as did not stop it.

[EdBacon in reply to spw1]

Sometimes retrying Xtandi after chemotherapy can work. This has been shown in clinical trials. I am doing it and so far it's working, but who knows for how long. I'll take whatever I can get.

[Univs in reply to EdBacon]

Just curious as I continue to develop my own arguments with my own MO but was your Dr supportive of the Xtandi rechallenge/chemo combo?

[meowlicious99]

> is initial PSA flare something to expect?

what was the flare. I checked your profile but couldn't see the flare in terms of numbers/percent. Looks like a an initial flare is not uncommon

ejcancer.com/article/S0959-...

I don't have access to full paper, found this on pubmed .

[Univs in reply to meowlicious99]

Thankyou