What next after Docetaxel...?

[Ollie1948]

On 4/19/23 I was seen by the trial MO to confirm the previous recommendation of 10 sessions of of Docetaxel after the new liquid biopsy confirmed the first one with no mutations. Meanwhile, the PSA has risen to 115 before a kidney issue and to about 350 just before Chemo.

On 12/06/2023, after 9 sessions of Docetaxel, the PSA has been stable all the time at about 360, and both CT and Bone scans show no progression, but the side effects of the Chemo became very strong and session 10 of 10 was cancelled. Basically not a winner.

I got 3 different opinions from 3 oncologists... 1. Try Xtandi and when it fails move to Cabazitaxel. 2. Take a break and start Cabazitaxel. 3. Take an unspecified break and do a PET scan.

Several options to proceed, like Cabazitaxel and Xtandi , as in the past my failure was with Abiraterone(Zytiga). Xofigo was ruled out based on my previous experience with Lu 177 and actual weak lab data. I elected to take a chance with Xtandi, probable another short term failure.

[Tall_Allen]

Combining chemo with Xtandi helps it last longer:

prostatecancer.news/2022/10...

[pilot52]

Hi, got your message, ok , I am a post Lu-177 child and did ok. Reduced a very hi tumor load . Returned 18 months later and had two more rounds. Fortis Health India. Have stayed on Lupron, Xtandi fails but Lu-177 seems to repurpose it for a while. I have developed a P-53 variant which makes Docetaxel less effective. My psa was doubling at a fast rate though very low because I am a slow emitter. Enrolled in a Pfizer Clinical Trial for solid tumors. Cannot tell you what I am on because it is a Phase 2a trial so there is little info. You can get the general description of what it is and what they are trying to accomplish. Clincal trials are demanding and I travel from Georgia to Dallas. It was every week now just first day of each cycle. Tall Allen is correct about combining . I cannot recommend any tx for your dx only relate my map. I am now a clinical trial baby and my MO is mostly research so we try to keep on top of it...Best of luck ..if this stuff had just one common denominator it would be much easier. However. it is individualized to the point you have to find your place...Not much help but I have been on and off Xtandi for 5 years. It is part of my trial now.....