ADT + darolutamide + docetaxel (ARASENS trial) has anyone tried it?

[Maxone73]

Hi people!

My first update since the diagnosis.

After less than one month of regrouping and ADT only (decapeptyl - triptotrelin, which got my PSA from 70 to 15), my MO decided to do the ARASENS trial triplet (with my full approval, I was going to propose him this protocol).

Has anyone tried it? Any suggestion?

Docetaxel 145mg for each cycle seems a big amount to me even if the MO keeps saying "you are big, young, in shape and you have no other condition" but still...

[AlvinSD]

Yes. I did it starting in May 2022. Gleason 9, Stage 4 when diagnosed at 52. Also had radiation in Dec 2022-January 2023. Super happy I did it.

Happy to answer any questions.

[Maxone73 in reply to AlvinSD]

Hi Alvin!

Was it hard to deal with docetaxel side effects? Did you get more side effects from darolutamide?

Thanks!

Max

[AlvinSD in reply to Maxone73]

My worst side effects have been from Eligard. Darolutamide has not caused me any issues at all. Chemo side effects weren’t horrible. I think I tolerated them well because of my age and otherwise great health and how I stayed active all through treatment.

Here is a post I wrote about Chemo

healthunlocked.com/advanced...

Please let me know how you do.

Bob

[Maxone73 in reply to AlvinSD]

Hi Bob!

Will do it! Hopefully my otherwise great health and frequent workouts will help me as well. I am quite scared but I think this triplet is the one that can give me the best hope at the moment!

[dhccpa]

Are you metastatic to bones/organs?

[Maxone73 in reply to dhccpa]

hi there!

Yes unfortunately, lymph and bones, not too bad, no pain (for now at least)

[dhccpa in reply to Maxone73]

Thanks. I've never been clear on exactly when daroutimide is used, as opposed to Zytiga or Xtandi.

[Maxone73 in reply to dhccpa]

Normally (at least in Italy) it's used as first line treatment for nmCRPC.

With ARASENS protocol (which is becoming a standard) they used it together with usual ADT + Docexatel (6 cycles) as first line for mHSPC to prolong the time to castration resistance and in general notably longer OS and progression free OS.

[dhccpa in reply to Maxone73]

After Googling it looks like it's now approved for metastatic patients in USA since 2022.

[Maxone73 in reply to dhccpa]

Yes I know but where I live it’s been approved as triplet only within the trial…damn bureaucrats!

[PGDuan]

I finished it in April and also had radiation. I was otherwise healthy at the start and it wasn’t too bad in hindsight. It seemed to work so far and I am feeling better every day now that I’m on the other side. Glad to have had the option.

[Maxone73 in reply to PGDuan]

Hi PGDuan!

I hope it will work well. OS and all the other parameters look pretty good compared to the other trials.

[Maxone73 in reply to PGDuan]

Can I ask you if you were oligo metastatic?

[PGDuan in reply to Maxone73]

Yes - I had likely mets on C5 vertabrae and 2 ribs (I think oligo is often <5 mets). My PSA was still really low (<1), but it was doubling quickly from the nadir after my first round of treatment. I also had SBRT to zap the spots on the neck and ribs.

[Maxone73 in reply to PGDuan]

Thanks for the info! We will see, if my Mets shrink maybe some could be zapped.

[Derf4223]

Max, it would help a lot for you to put some of your diagnosis and treatment particulars in your bio. Prior PCa if any, PSA at Dx, radiation if any, etc. And PS and BTW, welcome to the Hydra club. Do not underestimate this Hydra. Today's SOC has been arrived at by the blood and sweat of our forebears. Become familiar with the NCCN guidelines applicable to your case.

[Maxone73 in reply to Derf4223]

Done!

[j-o-h-n]

And your age is _________________? da da da da da da dum (Jeopardy theme)....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 09/28/2023 6:09 PM DST

[Maxone73 in reply to j-o-h-n]

50!

[j-o-h-n in reply to Maxone73]

50? Santa Merda!!!...........

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 09/29/2023 1:09 PM DST

[Maxone73 in reply to j-o-h-n]

Yes, that’s the concept!

[j-o-h-n]

🤜 🤛

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 09/29/2023 2:14 PM DST