Jevtana 3/26

[LuvLapsang]

Hello,

As promised, I’m opening a thread to chronicle my experience with Jevtana/Cabazitaxel. My first treatment was yesterday, 3/26/2025, and so far, I can report a mostly eventless 24 hours. Unlike Docetaxel, at least my Jevtana was preceded by a Benadryl injection, which did make me pretty tired almost immediately. By the time everything was administered, I was awake and alert enough to drive home without incident.

Once I got home, I did take a couple short naps while watching TV. No loss of appetite and no gastrointestinal hiccups. I didn’t get the best sleep last night, as I seemed to have trouble finding the best combination of blankets to balance an onset of hot/cold spells. Also, oddly, when I chewed my oral vitamin C tablet this morning, it didn’t have the same tangy bite I’m used to. I had some taste bud changes with Docetaxel, but I don’t remember them coming on so quickly. I’ll be making a mental note of other tastes as the day(s) go on.

Otherwise, smooth sailing so far!

For background: I’m Stage 4, diagnosed 12/25/2021, PSA over 2,000. Casodex for 30 days starting mid-January 2022, then 6-month Lupron injections starting February 2022 accompanied by Erleada, which was effective until May 2024. I had 25 trips to the radiation table October thru December 2023 targeting prostate and several skeletal mets. Began Docetaxel early June 2024 after significant skeletal progression, and finished my 7th treatment early October. PSA had been mostly undetectable level since April/May 2022, with escalations that required the aforementioned interventions. Most recent PSA spike went from 0.13 to 0.45 to 3.06 to 13.90 over the course of four months, which leads us where we are today.

I’ll be happy to answer questions, and I’ll do my best to keep the updates coming as they seem relevant to share. Take care, everyone!

[speranza10]

I think cabazitaxel is one of the best treatments available, it is often overlooked by some patients who prefer not to do it and I honestly don't understand why. It usually manages to control for a good period of time diseases that progress with docetaxel and in general it is very well tolerated, and if it is not you can also take it at a reduced dose. I hope jevtana works for you too good luck.

[LuvLapsang in reply to speranza10]

Thank you very much for this follow up. I remember discussing a potential treatment path with my MO when I was first diagnosed, and one of the questions I had was why Docetaxel is staged ahead of Jevtana if the latter is generally better tolerated and considered to be an effective treatment. I’m not sure now the reason that was given, but as it turned out, I endured seven doses of Docetaxel, so I’m hoping to go at least as far on this med. I appreciate your kind words of encouragement and support.

[Woodstock82]

I got excellent results from Jevtana.

What pre-meds are you getting besides Benadryl?

My pre-meds were dexamethasone, Benadryl, and Pepcid.

Because of the Benadryl, I was not allowed to drive at all on treatment day, even though I didn't feel drowsy.

[LuvLapsang in reply to Woodstock82]

Those are the three pre-meds I received, as well. I also started prednisone about a week before treatment began. Thank you for your experience on this chemo. Just hearing of your success is a big boost in my confidence.

[j-o-h-n]

Keep up the good work and the great posting here. Remember you can always see another M.O. for a second opinion or replacement. Thanks and as you said, keep posting here... it helps you and helps us too. God Bless!!!

Good Luck, Good Health and Good Humor.

j-o-h-n

[LuvLapsang]

Quick addition: PSA spike now went from 0.13 to 0.45 to 3.06 to 13.90 to 59.80 (as of 3/26) over the course of five months. I’m not as good at math as I used to be, but doubling time seems to be in the 7-day range. Good thing help is on the way.

[LuvLapsang]

I’d say my muscles are a little weak today, and my joints are experiencing some stinging, intermittent pain. Started last night, wasn’t too bad when I got up today, but it’s gotten worse throughout the day. Different than anything I felt with Docetaxel. Nothing that feels like an emergency. Just generally uncomfortable; I can’t find a position to sit where my body doesn’t hurt.

[LuvLapsang]

Okay, I feel like this is a pretty big update for a number of reasons.

I had my first post-treatment bloodwork done on 4/2, and I was stunned to learn my white blood cell count was 0.69. In other words, the Jevtana completely destroyed my immune system. I certainly wasn’t expecting that, and I’m upset because I was told during yesterday’s visit that it’s a known risk. Really? We’re right in the middle of people walking around with every cold and flu, and the fact I’m walking around normally without even the notion I could be at risk is unacceptable. Had I known there was a risk, I would have prepared to stay home. Also, knowing there’s a risk, my initial follow-up should have been done sooner than the standard seven days. This was a big miss for my care team, and I’m not at all happy about it. I was given a fast-acting white cell booster in the clinic, and I was sent home with two more preloaded syringes to self-administer today and tomorrow. I need to test my blood again on Monday.

Separately, I had a pretty significant gastrointestinal intestinal episode before bed the night of 4/2. I’m not as “regular” these days as I normally would be, and after a couple days of below average (or zero) output, I made a decent contribution Tuesday night. By decent, I mean rather large. Then last night (4/2), all hell broke loose, including a decidedly unstructured ending. That was followed by another unstructured trip. Then another this morning and another about five hours later. I don’t feel sick, so I’m not sure I can explain the change in circumstances. Maybe I ate something yesterday that didn’t agree with me. Or maybe it was the injection. I wasn’t forewarned, but then again, forewarning seems to be in short supply these days.

The fact that two care providers I respect kept cheerleading Jevtana as “better tolerated” really annoys me right now. I did fine with the 7 Docetaxel treatments I received, so “better” would have meant feeling like a trip to the candy shop. So far, Jevtana does not meet that description for me.

[speranza10 in reply to LuvLapsang]

Cabazitaxel can also be taken at a reduced dose for patients who do not tolerate the full dose. There have been studies comparing patients taking 25 mg/m2 and others taking the dose reduced to 20 mg/m2 every 3 weeks, more or less the efficacy was the same.