Doxcetaxel not working

[Knittingque]

Hi Everyone,

Firstly want to say thanks for all the responses to my last post regarding my husbands dreadful side effects of Doxcetaxel. Each reply was encouraging and informative.

After 3 infusions with Doxcetaxel and horrendous side effects, my husbands psa has climbed to 900 which is alarming.

The therapy has been stopped and he will be having a couple of scans to see whats going on as he has lymph node involvement. He is CR but no bone involvement as yet "touch wood".

His Oncologist is suggesting other therapies but until scans are done in a couple of weeks he won't know what they will be. We really do not want to go on another Chemo treatment ie Cabitaxel as only having one kidney, one adrenal gland and no spleen, it's been really hard on his body.

Since being diagnosed 12 years ago he has had Radiation to the prostate bed, Adt for 3 yrs, stopped that as psa stabilized then watch and wait for 6 years then cancer returned so back on Adt and an Orchiectomy Adt failed as he became CR. Then he tried Xtandi for almost 1 year and it too failed, Doxcetaxal for 3 months and failed.

He has been tested for Braca1 and 2 and shows negative.

Any suggestions as to what would be a good next therapy.

Thank you

[speranza10]

Cabazitaxel is different from docetaxel, it is generally better tolerated and more effective, it can also be done at a reduced dose. If there are no other therapies available and the physical conditions and blood tests allow it, it is worth trying. There would also be pluvicto but I do not know enough about this treatment, so I cannot tell you anything useful.

[God_Loves_Me]

I am NOT doctor , I am NOT medical advisor.

- Can MO referral for surgery that remove lymph nodes that impacted by cancer cells ? I know some users did it.

bupa.co.uk/health-informati....

- Schedule appointment with Radiations Oncologist may be they can radiate it. Many times MO say no for radiations but still go and see radiations oncologist

- Can he try TALZENNA® in Combination with XTANDI ?

pfizer.com/news/press-relea...

“The TALAPRO-2 results showed that TALZENNA plus XTANDI is the first and only PARP inhibitor in combination with an ARPI to significantly improve survival in patients with metastatic castration-resistant prostate cancer, regardless of mutation status,” said Roger Dansey, M.D., Chief Development Officer, Oncology, Pfizer. “Pfizer is dedicated to advancing scientific breakthroughs in genitourinary cancers, and these exciting TALAPRO-2 results further highlight our long-standing commitment to improving survival for men with prostate cancer.

[Tall_Allen]

A first step might be to request a biopsy of some of the metastases. Then they could do histology, IHC, and genomics. My "wish-list" for IHC (stains are not available everywhere) would be:

AR (androgen receptor), PSA, PSMA, MSH2, MSH6, STEAP1, PD-L1, PTEN, chromogranin A (CGA), neuron-specific enolase (NSE), synaptophysin (SYP),  DLL-3, CD56, Somatostatin (SST)

That would steer you in the right direction for clinical trials he might qualify for.

Meanwhile, you might try re-challenging him with apalutamide - sometimes docetaxel overcomes resistance. Also, discuss Provenge.

[j-o-h-n]

Hello Knittinqgue,

When it's convenient for you, would you please update your dear Husbands bio. You can glean some excerpts of your prior posts and copy and paste them in his bio. They will be helpful to you and to our members. Thank you!!!

Good Luck, Good Health and Good Humor.

j-o-h-n

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

Will do shortly. Thanks John take care and fight the good fight

[spencoid2]

Similar to my case. I had brachy 1 years ago, Not good at dated but when PSA started climbing afas wa put non AFT and shortly after orchiectony. Helped fora wole but t as obviously stage four and PSA doubling of 7 months or so. Tried doxytaxel and it gout me a few months? Could not do nuclear med like PLuvicto jf chemo naive so that was all that was available.

PLuvicto was cut short due to side effects and lack of a strong response. So here is the plan: wack a mole to the worst mets in terms of pain size and location. This has slowed progression a little but with different labs not sure of exact comparisons.Currently PSA is about 1900. at the same doubling rate it would have been over 2500.So started a jetvana and carboplatin a few days ago and the side effects are quite severe but this seem like my only hope at this point.

JUst astarted chemo again but