Chemotherapy Effectiveness

[JamesHughs]

Can anyone shed light on how long chemotherapy remains effective on the average?

[Tall_Allen]

For mCRPC or mHSPC?

[JamesHughs in reply to Tall_Allen]

mCRPC

[Tall_Allen in reply to JamesHughs]

The median duration of PSA response was 8 months. Over a third had a significant reduction in pain.

[Gl448 in reply to Tall_Allen]

what about for mHSPC?

[Tall_Allen in reply to Gl448]

median 37 months.

[Vegasborn in reply to Tall_Allen]

is this based on the newest clinical trials for triplet therapy? TIA.

[Tall_Allen in reply to Vegasborn]

No- based on docetaxel trials.

[AlmostnoHope in reply to Tall_Allen]

I agree. Docetaxel is a horrible drug.

[EdBacon]

Based on a recent clinical trial comparing Cabazitaxel chemotherapy with switching anti-androgens: "The median imaging-based progression-free survival was 8.0 months with cabazitaxel and 3.7 months with the androgen-signaling–targeted inhibitor."

nejm.org/doi/full/10.1056/n...

[MrG68 in reply to EdBacon]

Wasn’t that just for the imaging progression? The overall survival being 13.6 and 11 month’s respectively?

‘The median imaging-based progression-free survival was 8.0 months with cabazitaxel and 3.7 months with the androgen-signaling–targeted inhibitor. The median overall survival was 13.6 months with cabazitaxel and 11.0 months with the androgen-signaling–targeted inhibitor (hazard ratio for death, 0.64; 95% CI, 0.46 to 0.89; P=0.008).’

[Woodstock82]

When I became castrate-resistant, my treatment changed. Lupron was continued. Zytiga was added. Six rounds of Jevtana were endured.

The last chemo was in the first week of March 2021. Now 22 months later, I am still on Lupron and Zytiga and my PSA is still just barely detectable. Scans every three months continue to show no growing mets, no new mets.

So far so good.

[EdBacon in reply to Woodstock82]

Thanks. I'm curious, as someone who actually has advanced prostate cancer (thanks for sharing the details in your profile), was it worth doing for you to stay alive? That's the bottom line. For me, the answer to that question is YES.

[Woodstock82 in reply to EdBacon]

Absolutely yes. My back pain was very bad. Eight out of ten at one point, before I started treatment. My back pain has been at zero or one for over three years now.

[EdBacon in reply to Woodstock82]

Thanks. I also got complete pain relief for a while, and I could see my numbers improving at the same time. So I know it was killing the cancer.

[AlmostnoHope in reply to EdBacon]

You guys are the toughest Men in the World.

[maggiedrum]

Chemo is next SOC for me if things get worse and I decide to get it. After seeing all the comments about lower side effects with Cabazitaxel versus Docetaxal, I looked up both. From the relatively current requirements I found, SOC is to start with Docetaxal and only after failure of that can you get Cabazitaxel. Any other info on that?

[Blue-Mockingbird in reply to maggiedrum]

I’d be interested to know also. My husband had Docetaxal in 20/21, has become castrate resistant after both Bicalutamide and Abiraterone stopped working. Thought he was going to qualify for BAT but don’t think that’s going to happen now. MO says next possibility is more chemo but she hasn’t said if they’ll try the Docetaxal again or a different chemo med

[EdBacon in reply to Blue-Mockingbird]

They like to wait a while before rechallenging chemo. But if he had it in 20/21, that's long enough providing the doctor thinks it was working. Usually that involves looking at the PSA rise or fall after stopping chemotherapy. My doctor told me if the PSA goes back up within 6 months after stopping chemotherapy, he doesn't think it's worth rechallenging. That was the case with me, so we moved on to Cabazitaxel.

[noahware in reply to Blue-Mockingbird]

Was the BAT going to be in a clinical trial, or was it going to be done independently by your MO (by following trial protocols)?

[Blue-Mockingbird in reply to noahware]

I believe it was going to be done by his MO following trial protocols.

But alas, he won’t be in the BAT trial after all. His MO called yesterday with the news that my husband’s PSA has doubled in the last month so she wants him to have more chemo treatments to get him back under control. This time they’ll give him Cabazitaxal. He says he’s okay with it, just hates losing his hair again

[EdBacon in reply to Blue-Mockingbird]

Most don't lose their hair with Cabazitaxel.

[Blue-Mockingbird in reply to EdBacon]

Awesome! I’ll let my hubs know 👏🏽