Docetaxel + Carboplatin not effective!

[Justgettingitright]

unfortunately my dads PSA is still increasing even after receiving docetaxel + Carboplatin. He completed DCT in December and Chemotherapy started in December 2024. He got 4 infusions of carboplatin and Docetaxel but PSA is rising again.

Nothing seeems to be working for my old man. He is still asymptomatic and has no complaints whatsoever.

Abireterone was discontinued at the start of chemo and he is not on any medications while on chemotherapy. Do you think that he should start with enzalutamide or darolutamide along with chemotherapy?

[Tall_Allen]

Cabazitaxel is often beneficial after docetaxel fails.

Enzalutamide had extended benefit when used together with chemo in the PRESIDE trial:

prostatecancer.news/2022/10...

[MarylandGuy in reply to Tall_Allen]

Would nubeqa also work better with chemo?

[Tall_Allen in reply to MarylandGuy]

Possibly, but it hasn't been tested for mCRPC.

[Justgettingitright in reply to Tall_Allen]

Thanks for the quick response Tall_Allen

When should keytruda be administered? Is it now or do we wait ?

[Tall_Allen in reply to Justgettingitright]

Discuss that and APCEDEN with your oncologist.

[Justgettingitright in reply to Tall_Allen]

He received APCEDEN vaccine. Completed 6 vaccines in DEc 2024.

[spencoid2 in reply to Tall_Allen]

Doxy did not do too much for me maybe a year ago. Did pluvicto three treatments an it wa stopped due to minimal benefit and serious side effects like persistent xerostomia.

Will have second cabazitael plus carboplatin in two day. Do not have results of last PSA (after first chemo) because they send it out to an external not being able to test over 1000 or so

Really hoping this will be effective. Do not know what else might work?

[Nigel2023]

Hello, I have been through just about everything available for metastatic prostate cancer and would be glad to help. I will offer the following comments. Please feel free to contact me directly if you have any questions.

(1) I had 11 doses of Docetaxel (normal dosage here in the US is 6). I started taking Abiraterone just before starting chemo and it reduced by PSA from 50 to 30 in one week. At the time, it was not FDA approved with chemo but I insisted and stayed on it. Chemo was from Feb 2022 - Sept 2022. PSA graph is attached. I insisted on waitlist for Pluvicto as I was not satisfied with the chemo results. Fortunately I was accepted and had 6 infusions Nov 22 - June 2023. You should be eligible for Pluvicto if you test positive on a PSMA PET scan. As you can see from the graph, I had mixed results during the infusions but downtrend and had not treatments after for about a year other than Lupron and Abiraterone. On recurrence after the hiatus, I got into an Actinium trial and just completed my 8th infusion in Omaha NE. Again, mixed results but downward trend. Current PSA is 3.5.

(2) Highly recommend you secure an oncologist with access to these advance treatments.

(3) And always get second and third opinions

I hope this helps...

Three Year PSA

[Nigel2023]

Here is my Two Year PSA (I could only attach one JPEG per message)

Two Year PSA

[Justgettingitright in reply to Nigel2023]

Thanks for sharing this information. Unfortunately, my dad is not a good candidate for Pluvicto. That’s what I have been told by his oncologist.

[Knittingque]

Once you have Enzalutimide with or without chemo you cannot go back to Darolutimide with or without Chemo l was told . Good luck