Life After Cabazitaxel

Houseboy,
So sorry you are seeing a rise after one tx of cabazitaxil, but perhaps the rise is an anomaly and not a failure. Are you getting another round to see what happens. I assume the lung bx will be looking for neuroendocrine mutation, which would change your tx to platinum chemo. But if it hasn't mutated, then perhaps xtandi would work following the chemo regiment if it's available to you. If not, then you could possibly try for mitoxantrone, which is what my DH is doing after all other tx options were exhausted.
I hope you are able to get the lung mets under control.
Beth

Hi Beth:
Many thanks for the response. I have been following your postings and various treatments. Impressive!
My signature does not explain that I have had 4 treatments with Caba and yet progression on the CT Scan after 3 treatments is taking place. I continue with Caba pending being a candidate for the PARP and/or Keytruda trials starting in the next two months, hoping that Caba still contains some benefit until then. I also am pursuing radiation to the moderate pleural effusion to ‘debulk’ somewhat the ‘mother ship’ load of PCa. In that vein, platinum chemo is an exclusion feature of those trials, but may be useful if I fail as a candidate. I was not aware of mitoxantrone and I will raise that with my two Oncs. There is a good literature summary on UpToDate website which discusses it.
I had a good two years on Zytiga, but my try at Xtandi failed. However, another option is to retry Zytiga. Hopefully, with a new biopsy, the oncs can test for sensitivity to these various options without using me as the guinea pig. I will keep you updated.
Nomar, good to see you are progressing well. Thanks for the note re Tall Allen.
Houseboy

Thanks, Rick. I did try Xtandi after I came off of Zytiga, but it did nothing (cross resistence).

My Onc wants to try to re-challenge Zytiga. I think I will go for it.

I hope your Jevtana continues to work as well as it is.

Nomar, I have trouble finding Tall Allen's email address. Can you refer me?

Houseboy

Sorry I missed your thread, but I see that Beth has given you some good tips. BTW - if you click on "Tall Allen" in the box on the left, my email should show up.

I agree that Keytruda and PARP trials are great ideas. PARP, if the biopsy proves amenable to such treatment. In the US, some of my favorite "throw everything but the kitchen sink at it" trials are these (check qualifiers/disqualifiers):

Zytiga, apalutamide, Ipi, Jevtana, & Carboplatin (MD Anderson

Apalutamide, Zytiga, & Taxotere (multiple locations)

cycling the following: Zytiga+Xofigo, Jevtana+Carboplatin,Xtandi+Xofigo (Mt Sinai)

If you can afford medical tourism to Germany for a period of time, Lu-177 and a few other experimental nuclear medicines show some promise. Scott Tagawa at Weill Cornell told me he plans an expanded US trial soon.

Hi houseboy,
Did you get a chance to check out any of those trials for exclusions? If you can get in one with zytiga, or if you try for a rerun, you might have better luck, because sometimes chemo in between helps it to work again. TA could give you the medical explanation an the trials that support the idea of chemo prior to zytiga.
I have been trying to convince Gary's medonc to consider zytiga and xtandi combo, but he is convinced it would do more harm than good.
Best of luck in your next tx choice.
Beth

It looks like a great study - I hope you get in.

Special Lady, You made my Day!

I have 2 daughters, one a family doctor and the other a PhD in law. I am certain your Father is as proud of you as I am of my daughters in pursuing Quality of Life for him as long as one can. Congrats on being there for him, and Good Luck! I will let you know by posting here how I make out on the Trial.

Tall Allen, as ever, you are there to help us all in making common sense decisions in our constant battle with this disease. We all owe you a great deal!

Season's Greetings to All
Houseboy

Your name "SpecialLady" is well chosen!
Houseboy

TA, thanks, I have followed Celebrex for years, ever since those receptors were identified (I sent the samples to Dr.Bonkhoff in 2012), and was aware that apart from mice and lab and some small trials, its efficacy could not be proven. Until recently, the STAMPEDE trial. I agree, it must be a subgroup of patients with COX-2 receptors. Just like some angiogenesis drugs would possibly work for those with VEGF receptors. My father was tested for those, too, and was negative. We may need to wait a while for the genetic testing to prove completely useful, when a safe technology is established for gene editing.