Cabazitaxel plus Carboplatin

Who has been treated with a combo of Cabazitaxel plus Carboplatin? What was your experience? How well did the treatment work?

I had six round of Docetaxel and might need to do Cab & Carb now. I found a few threads mentioning the combo, but not a full report about the whole experience and the results.

Your input is greatly appreciated!

Hi Beth,

Thanks for your comment. You are right, this cocktail is not a standard treatment option for PCa.

Here is why I am looking at it: So far my cancer has clearly been normal PCa. Now, a recent biopsy of a suspicious lymph node showed a few pockets of squamous cells, a mutation of the original cancer.

In order to treat this we will do a lymphadenectomy (surgically remove the lymph node). After the surgery I might do several rounds with that chemo cocktail to make sure that this mutation, which can be very aggressive, does not spread. This mutation does not express androgen receptors and is therefore not reacting to ADT. It does however respond to the treatment with Cabazitaxel plus Carboplatin.

Best - Madagascar

Dear Madagascar ~

Our paths have crossed several times on this forum, and I always follow your posts with great interest --- and both of us have already been through a series of Taxotere chemotherapy treatments, I know ...

I wish I had greater insight to offer to your specific question ...

On my trip to Mayo Clinic in Rochester, Minnesota, I do remember Dr. Eugene KWON mentioning "carboplatin" --- I don't have any specifics to offer you, however ---

In Dr. Kwon's treatment practices, he spoke directly to me about different combinations of chemotherapy treatments that he uses for his prostate cancer patients. He looks at each individual case, decides which chemical "cocktail" might benefit the patient the very most, and then orders these specially mixed "chemo cocktails" in certain cases --- Dr. Kwon has them individually mixed and compounded, based on his specifications for advanced patient needs, he told me in person --- rather than just the "textbook" standard chemotherapy infusions.

It was in the context of that conversation in Dr. Kwon's consultation room at Mayo Clinic a few weeks ago that I distinctly remember Dr. Kwon mentioning his use of "carboplatin" in some of his "chemo cocktails" --- based on the needs of the patient --- Dr. Kwon being a noted "urology oncologist" in the urology department of the Gonda Building at Mayo Clinic in Rochester, Minnesota.

I truly wish I could offer you more detailed information --- you have always been a friend of mine on this board --- meanwhile, you have my ongoing thoughts and prayers and continued support --- I have thought of you a great number of times and continue to hope that you are having success with your treatment path.

Meanwhile, my E-mail is included in my profile, if there is ever a time that I could offer you any advice or moral support. I have always appreciated your supportive messages on the board in the past.

Thanks for being a "brother on this board", past and present, Madagascar !

Sent with my best,
Iowa State "Cyclone"

Post Edited (ISU-CycloneFan) : 12/6/2015 6:13:08 PM (GMT-7)

My husband will start chemo with Cabazitaxel and Carboplatin on Tuesday Jan 19. He has not had any chemo before now and is not considered neuroendocrine at this point. He has mets in his bones only (had them at diagnosis 2 years ago). There is not much info out there about this combination and its effectiveness so I will be following any threads I can find.....and posting when I have something to add as we go along. I would appreciate links to any articles or information.
Thanks
Angie

A man in my support group had G9 at diagnosis and radiation. After a year or so he recurred and went through hormone treatments in quick order and after nearly two years found himself at MDAnderson with psa of 400+ and numerous metastases. He started Carbo+cabazaitaxel and his psa has gone to 40 after two cycles of a single day of treatment every three weeks. Much improvement in scans also. He flies 1000 miles each way each time wearing a surgical mask. Trouble and expense but worth it for him he says. Usual side effects and no myelo suppression so far. I assume that MDA diagnosed neuro- from his history, stats, samples. First such case I was aware of.

Beth,
You're right that the platins are usually reserved for aggressive variants, and if possible, I think it's a good idea to biopsy some mets and do the bloodwork to detect those variants. Sometimes normal PC evolves into one of those, or possibly ADT puts selective pressure on variants that don't express the androgen receptor. Sometimes they express novel receptors instead, like somatostatin, which can be a therapeutic advantage. I think the taxane (docetaxel or cabazitaxel) is in the cocktail to control the normal PC, and the platin is there for the other stuff. I know there are some clinical trials for taxane+platin in advanced PC. Sometimes they add etoposide, epirubicin, or estramustine into the mix. After taxanes fail, those other kinds of chemo are often tried -- what is there to lose?

Docetaxel resistance may occur, and cabazitaxel often works after docetaxel fails. There was an interesting lab study recently that demonstrated that docetaxel resistance could theoretically be reversed with a glucocorticoid receptor antagonist, such as RU-486 (the day after pill) or cyproterone (a kind of ADT used in Europe). Since it is cheap and pretty safe, it may be worth a shot.

- Allen