Trial of Docetaxel + Xofigo (Radium 223). I Start Monday

Since I have metastatic castrate resistant prostate cancer, I have been looking for trials to enter. The trail with Ribociclib was not successful for me because of the heart issues it induced.

Xtandi also has been ineffective without the ribociclib leaving me with rising PSA...

I’m entering into another trial sponsored by Sloan Kettering Memorial cancer center. I traveled from Rochester to Buff. to Roswell park cancer institute to take part in the ribociclib trial. This trial is here in Rochester. I have noticed a couple differences between the two sites. RPCI has a very clean process since cancer and cancer trials IS what they do. WILMOT is a part of the University of Rochester Medical Center so scheduling is it quite as cut and dried there. So far I have had the labs and the CT scan and I will be returning there Monday to get the Docetaxil and since I am in the test arm, I will also be getting the radium 223 either Monday or Tuesday. This is not a blinded trial so there is no placebo. 10 chemo doses, 3 weeks apart, plus 6 Xofigo doses 6 weeks apart. (and Xgeva to support my bones)

Has anybody else tried this combination? Chemo plus radium 223 at the same time? Does anybody have any stories about XOFIGO that they want to share? You guys n gals have been a great resource, and encouragement. I hope to bring good news from this experience.

While I don't have any knowledge of a trial with such a combination, it would seem to make all the sense in the world. There are lots of Xofigo reports out there where the scans show amazing shrinkage. Worth some digging to see just how impressive the drug can be. I hope this trial works beautifully for you. Personally, I am in a similar trial with 177-Lutetium, referred to as the VISION trial. No idea about the relative toxicities, but that is why we do the tests. Very best of luck to you with it.

Not kidny stones.. You already had dosetaxal, it's the same as taxotere which you have already had..But combining it with the R-223 might be a whole new ball game. Best of luck to you...

Best of luck with your treatment. And thanks for being a part of the trial.

I got my chemo on Tuesday. I got my Xofigo on Wednesday. the doc who injected the Xofigo is a hoot! I have radioactive pee for 3 days...Other than that, there is no public risk, as Alpha particles emitted by Radium 223 can be blocked by a sheet of paper. I can go through borders or fly without setting off any alarms.

I'm going to get Xgeva to support my bones. To get that authorized, I needed a note from my dentist. Basically, he had to say,'we don't intend to do any dental surgery on this man in the near future, so we authorize the Xgeva'. Xgeva can cause issues with the re-growth of dental bone following extractions, or surgery.

(Caveat: 1st dose only at this point) I do feel a bit of fatigue, and my tendency toward diarrhea with continuing Lupron seems worse. As part of the trial, since my trial arm includes the Xofigo, the dose of chemo is smaller than the doses I got last year. Maybe I won't lose my beard this time?

Ill have labs with my next dose, and I'm hoping for a nice drop in PSA... It was 49 last week.

As noted above I did have Docetaxil last summer. On this trail I’m getting docetaxil with Xofigo. Last year with Docetaxil I didn’t have any chemo crash after the first infusion. I did have dry tongue after the first infusion.

My 1st infusion/injection combination October 15/16, with the combination of chemo and Xofigo I had a noticeable increase in fatigue during the first two weeks which improved during week 3. Instead of visiting the gym 2-4 times a week, I found myself napping (40-90 minutes) about that often , in order to have the energy to do my job. I did not have the dry tongue during that time (because the chemo dose is smaller?)

Monday 11/4 I got my 2nd dose of chemo. Today 11/5 my tongue is dry. My white blood cell counts have not dropped as precipitously as they did the first time I had chemo. When they dropped so badly last time, I got Neulasta to support my immune system. I’m not scheduled for Neulasta at this point in time. I got a shot of Xgeva to support my bones on Monday.

I did not see my PSA drop as I had hoped. Instead it increased from 49 to 75. I have been reassured that with this protocol sometimes it takes two or three doses of chemo to get the PSA level to drop. Next visit: 11/25... wish me well!

Wow, what a busy week. I hope everyone had a good Thanksgiving.

I got chemo and Radium 223 (Xofigo) both on Monday the 25th. My sense of taste is somewhat diminished, and I’m not as energetic as usual. The latter is an expected SE of Radium. My energy should return next week... Diarrhea’s a concern. Imodium is my friend, and eating nachos with lots of cheese is a great way to help with that as well... I did not have mouth sores last year with chemo, but may have developed 1 or 2 this week.

I’m currently on FMLA leave, so my sagging energy level doesn’t make me take naps in order to be on top of my game at work...Labs do not show a need for Neulasta. I did have a strange sore throat that stayed with me for over a week. Urgent care (Saturday) tested for strep, negative.

My PSA has begun to drop, on schedule; to just above 68...

Hello!

I want to award you a BADGE OF HONOR, for blazing the trail for others, by jumping into a clinical trial.

From every trial, something is learned --- and it is the path forward, for new treatments, new medications, and new combinations of existing treatments, put together in new sequences or combinations.

I hope you reap benefits --- that help you today, and that will lead the way for others to be helped down the road.

I have been helped, since my diagnosis, with newer medications that wouldn't have existed a decade or two ago. I'm mindful of the hundreds of volunteers, who took a leap of faith, took a risk, and tried the medications and treatments that have helped me … TAXOTERE, ZYTIGA, PROLIA, ZOLADEX, LUPRON, and the list goes on.

We can't just "get there from here" in a direct route. It takes time, it takes courage, it takes testing, it takes fortitude, it takes incredible patience, it takes tenacity, and it takes VOLUNTEERS like you.

From every test, SOMETHING is gleaned.

I'm thankful for your post, and your willingness to help others by your participation in the trials and testing.

All my best,
CYCLONE ~ Iowa State University

Thanks for your kind words, Cyclone... I read somewhere that people in Trials get the best care; we’re certainly the closest monitored. Since I don’t fancy any surprises in this experience, it’sa natural to me to apply for trials. Some times Trials are restrictive (e.g. what supplements you’re allowed to consume during the trial) but I’ve been fortunate to get the test drug in both cases so far...

Here are two paper that may be of interest. Chemo is discussed.

Current approaches to incorporation of radium-223 in clinical practice [2018, Full Text]

The Contemporary Use of Radium-223 in Metastatic Castration-resistant Prostate Cancer [2018, Full Text]

Earlier studies appear to have dealt with sequential, rather than combined, use.

Djin

You're very welcome. Good luck !!

Djin

NKS,
Thanks for the update. Sorry about the Bills. Hang in there and good luck!

Good luck withe trial....
God Bless