Please boys, girls, can anybody advise or help explain why combined carboplatin & etoposide chemo are going to be used in next treatment

Brief history

Hubby diagnosed Nov 21, straight in at stage 4, psa 600. Mets in spine and lymph nodes. No symptoms. Age 69.

Started Firmagon monthly injections immediately, he’s still on them. Psa dropped to 1.42, at which point docetaxel was started. 6 sessions later psa 8. Continued with 4 sessions of cabataxel, psa went to 150. Changed oncologist. Started xtandi October 22, psa went down to 115 fist month up to 210 second month. Waiting for psa test in the morning. Scans last week shows signs of more cancer in spine and ribs and pelvis. Met now in one lung too. Palliative radiation starts this morning on 4 mets on his spine. New oncologist emailed to say stop xtandi two days ago. He said he will start him on carboplatin and etoposide chemo after his radiotherapy.

Can anyone shine any light on these two combined chemo treatments. I know carboplatin is good for the lung met and is a platinum based chemo. I’ve looked up etoposide and can’t find much about it, other than it’s an old drug, used for small cell cancer, but I thought small cell cancer gave a low psa reading, hubbys is high.

What should I be asking him by email before our appointment in 2 weeks, and should hubby be having no treatment for 2 weeks. We live in France.

Desperately seeking any help, advice on this , thank you, Ginny

[tango65]

I would request a liquid or direct biopsy to do genomic, IHC, and histological studies to see if the cancer may be controlled with olaparib, keytruda or similar drugs. These studies may help in selecting clinical studies.I would also consider consulting with Dr Beltran at the Dana Farber in Boston

dana-farber.org/find-a-doct...

or Dr Aggarwal at UCSF

ucsfhealth.org/providers/dr...

[Hidden in reply to tango65]

Hi Tango, thanks for reply.

We live in France .

[tango65 in reply to Hidden]

Dana Farber does international consultations

dana-farber.org/for-patient....

[Seasid in reply to Hidden]

About guardant 360 liquid biopsy:therapyselect.de/en/guardan...

[EdBacon]

From what I know: This combination is typically given to patients with neuroendocrine differentiation which has features similar to small cell lung cancer. Here's a link to an article.

researchgate.net/publicatio...

[Tall_Allen]

The cancer is resistant to the normal taxane-types of chemos. Given what is available, what would you like them to do?

[Hidden in reply to Tall_Allen]

I don’t know Tall-Allen. I’ m just not ready to loose him yet. My sister died last Tuesday from Glioblastoma, brain cancer. She was diagnosed 3 weeks before my hubby. He is as I type having radiotherapy on his spine. I’m sitting here quietly sobbing my heart out. Head is all over the place. Need help and advice please

[Tall_Allen in reply to Hidden]

I'm so sorry to hear about your sister. That is a lot to deal with all at once.

[Hidden in reply to Tall_Allen]

It’s a living nightmare TallAllen

What I want to know, is this chemo the only option that he has left or are there others when this fails which it will invariably do at some point.

[Tall_Allen in reply to Hidden]

There are no more standard chemo options.

[Hidden in reply to Tall_Allen]

Are there other options other than chemo? Anything at all?

[NickJoy]

I'm really sorry things are so very tough for you at the moment. Has your husband had a psma scan ? You could check to see if he is a lu177/ac225 candidate. I think there is an allowance within the EU to travel anywhere that there is an approved form of treatment available which is not available within the healthcare system of your country, if so, you could check to see if LU is approved in Spain/Germany etc and claim back the initial cost? Maybe ask the oncologist as I might have got this wrong. Also, I think Oliparib was recently approved for prostate cancer in EU together with abiraterone. Again, check with oncologist if u can as they will know if appropriate right now. I hope the radiotherapy stabilises everything. Thinking of you. Take care.

[Skippy3]

Please read “Rusland’s” post and replies on his treatment with lu177/ac225. His PSA reduction after treatment is most impressive. He received some treatment in Germany. He will answer a personal message.

[Karmaji]

d u go to Ville juif ... Consult their group...very difficult to get right PC onco in France

I tried IPC Marseille....very ordinary know how....

[Hailwood in reply to Karmaji]

Qu'est ce que "ville juif"?

[doc1947g in reply to Hailwood]

Jewish City

Villejuif is a commune in the southern suburbs of Paris, France. It is located 7 km (4.3 mi) from the centre of Paris.

[Hidden in reply to Karmaji]

We are with Dr Loic Mourey at Toulouse Oncopole

[Hailwood]

Merci