Update on cabazitaxel

[Arcticfox44]

I started chemo with cabazitaxel on July 3 here in Nicosia, Cyprus, where I live. PSA at the start was 83. It fell to 61 after the first treatment, and way down to 20 after the second on July 24. The third treatment was yesterday, July 14. I had chemo with docetaxel in 2022, when PSA fell from about 60 to about 8, but no lower. Late in 2022 and early 2023, the Mayo Clinic sent me to the Anadolu Clinic in Istanbul for radiation with Lutetium-177, but this didn't seem to work. After Guardant testing at the Mayo, I'm a candidate for Olaparib and we may try it. There are some problems about getting the drug here in Cyprus so I would probably return to Rochester for that.

One unusual development: between the second and third treatments here with cabazitaxel, I had bleeding from the bladder which made urination difficult even with catheters, since the blood was clotting. I had a scan, which showed quite a large mass in the lower bladder but it wasn't clear how much of this was just blood. The next day I saw a urologist at a different private hospital, and by then the mass was reduced in size, bleeding had decreased, and I was able to urinate without a catheter. The urologist put me on an antibiotic for 10 days, now completed, and I'll see him again early next month. He wants to look at and possibly remove whatever it is at or near the junction of the bladder and urethra. Longer term, I expect to be back at the Mayo in early November.

I'm wondering if the bleeding episode may have been a direct result of my chemo. The Mayo says this type of bleeding does happen with cabazitaxel. I'd be interested in anyone's thoughts on how low we may be able to get with PSA on this chemo, and how durable it might be. There is the option of adding Olaparib, or waiting until the end of the chemo treatments, projected to be as many as 10, and then moving to Olaparib.

[mypk]

Just my own experience:

1. Docetaxel led to slightly reduced bone metastases and a significant drop of PSA from a maximum 1260 to approximately 85.

2 Cabazicaxel (11 times) just resulted into mainly stable bone metastases, a short reduction (during the first 3 cycles) of PSA which rose steadily again during the remaining cycles.

As long as I got Cabazitaxel, it was aggressive against the mucous membranes in my bladder and ureter, which led to regular episodes of small bloody flakes of mucous tissue in the urine as well as frequent strong urges to urinate, even when the bladder was still almost empty. In my case, this was an antibacterial inflammation of the mucous membranes. The pathologists could not assign the type of tissue to a specific type. It quickly returned to normal after stopping Cabazitaxel.

[Arcticfox44 in reply to mypk]

Thanks. This bleeding is apparently quite common.

[j-o-h-n in reply to Arcticfox44]

Yiasou patrioti........

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 08/16/2023 7:57 PM DST