Over 80 years - triplet therapy ?

[Tinkudi]

Anyone here who has tried triplet therapy for prostate cancer spread to bones. ?

Any experiences ?

[God_Loves_Me]

I know someone who did at age of 85.

[Tinkudi in reply to God_Loves_Me]

Do you know how well he tolerated it

[God_Loves_Me in reply to Tinkudi]

He was under Palliative care. I think he did good.

In my opinion everything dependance on blood work and health. Every person has different response.

[TK934]

Hi! My husband started triplet therapy last August. chemo/Eligard/Nubeqa. Last June, the scans showed multiple bone tumors, and while we considered other treatments, there wasn't much time. We started the triple therapy. He did well with the chemo (only issue was fatigue), and the PSA numbers continue to drop. Fatigue is no longer an issue and he feels great! Feel free to reach out if you'd like to discuss further.

[Tinkudi in reply to TK934]

Thanks. I see your husband is much younger to my dad who is 83.

Did they start all the 3 together ?

[TK934 in reply to Tinkudi]

They started the Eligard first ahead by 3-4 weeks, but then started the Nubeqa and chemo on the same day. (In fact, I had to make a special trip to pick up the Nubeqa while my husband was in the chemo session ... they were quite explicit that the two start together. ) The chemo was every three weeks for six times, finishing about 4 months later. Very tired, but the numbers went down. Scans after six months were good. Wishing you the best.

[PGDuan]

I did - SBRT + Nubeqa + Docetaxel. This was following recurrence after EBRT + 18 months Zytiga.

As for me, I'm glad I did it. I've been off all meds for 1 year now and PSA remains undetectable. The side effects were bad but not unbearable - fatigue, soreness, lost some hair and weight, etc, but it's behind me now (at least for this round).

I'm 58 and feel like all the treatments aged me quite a bit but it also kicked the can down the road, hopefully for a few more years when even better treatments may be available.

In terms of timing, I recall starting with a painful belly injection (degeralix) to drop testosterone asap, then the SBRT to spots on the rib and vertebrae, Nubeqa, and docetaxel all followed about a month later.

[Shams_Vjean]

Might consider talking with his MO about the ‘Finland’ chemo protocol as part of his triplet therapy; i.e., a lower dose of taxane delivered every 2 weeks, instead of the traditional full dose every three weeks. It’s been reported as better tolerated with the same degree of efficacy. I believe Oliver Sartor at Mayo Clinic in Rochester, MN might have switched to this protocol as SOC for some of his PCa patients.

trepo.tuni.fi//bitstream/ha...

Cabazitaxel instead of docetaxel is an alternative sometimes chosen for older patients

[Tinkudi in reply to Shams_Vjean]

Thank you. I will check that out

[Tinkudi in reply to Tinkudi]

I see you had chemo first and then you started the ARPI after it finished. I thought triple therapy meant all are started around the same time

?

[Shams_Vjean in reply to Tinkudi]

All at once was the protocol for the Peace 1 trial. Since how the 3 drugs are combined is not restricted by their “on label” use, an MO has some latitude for deciding what combination or sequencing is tolerable for the patient.

When I was getting chemo the ‘Finland’ protocol hadn’t yet been published, otherwise I think I might have all 3 at once using the easier chemo protocol.

I progressed at the mean of the trial timeline nonetheless. Would I have stayed in the HS phase longer if I had the strict trial protocol? No way to know for certain, I’d say.

[Tinkudi in reply to Shams_Vjean]

can you pls explain what you mean by -

I progressed at the mean of the trial timeline nonetheless. Would I have stayed in the HS phase longer if I had the strict trial protocol? No way to know for certain, I’d say.

[Shams_Vjean in reply to Tinkudi]

Trial noted mean lengths of time (from start of therapy) for both radiographic Progression Free Survival, aka: rPFS(from hormone/castrate-sensitive to hormone/castrate-resistant) and for Overall Survival also.

I progressed to “resistant” at approximately the length of time noted by the trial as the mean #of months from start of therapy to radiographic Progression(cancer growing again)

[Tinkudi in reply to Shams_Vjean]

Ok thanks. You mean to say your therapy worked for you similar to what the triple therapy timelines are

[Shams_Vjean in reply to Tinkudi]

Correct