Docetaxel for CRPC after 9 years of HT

Hello all,

I'm here to try to find answers for my 83 year old father who was diagnosed with PC in late 2011 when he was 74. He originally went to the doctor for pain in his hip, a scan showed lesions in his hip, shoulder, and on his ribs, a biopsy of the lesion in his shoulder came back positive for PC and his PSA was slightly over 1500. He lives in the St Louis area and was treated at the Siteman cancer center with HT, a shot every 3 months and a pill that he took at home, I'm not sure what the exact drugs were, he also received a round of Zometa in a trial. This brought his PSA down to 0.02 and the pain in his hip went away, he has and still does feel great with only some occasional hot flashes as a SE. He is very active and either walks, rides a bike , or kayaks 5 times per week for 1-1.5 hours. He's never had a biopsy of the prostate, no surgery, or radiation, his doctor said it wasn't necessary.

Last year, while he was still feeling fine, his PSA started a slow rise and his most recent PSA was 2.79, the pill that he takes was changed to Xtande with no help. His present doctor, Peter Oppelt, told him that he would need to take CT; Docetaxel and prednisone, every 3 weeks from now on and he told him to quit taking the Xtande. He had his first dose last Friday, January 29th, and day 3 and 4 were rough for him with nausea, sleepless nights, bone pain, and no energy at all, last night was the first night he was able to sleep and today he says he feels pretty much back to normal, I live 400 miles away in another state so I'm going by what he says on the phone.

It looks like most people here who are put on Docetaxel, get it every 3 weeks for 6 cycles and then they are done with CT and rely on HT with Zytiga or Xtande to keep their PSA under control. We are trying to figure out the advantages of CT every 3 weeks from now on over CT every 3 weeks for 6 cycles to see if it's worth the discomfort that it causes.

A search for Docetaxel or taxotere yields a lot of results for it's use at the beginning of hormone treatments but there is not much info for it's use on later castrate resistant PC so if this has already been discussed please direct me to the link for the topic and if not we would like opinions and or experience for Docetaxel use on CRPC for both treatments, continuous 3 week cycles, and 3 week cycles for 6 cycles and done.

Also are subsequent Docetaxel treatments side effects normally the same as the first, worse, or better?

Djin,

Thanks for your response, after reading those links it looks like >8 cycles is more helpful?

Hopefully someone that has done the Docetaxel for CRPC will chime in too.

From the abstracts it appears that the first article cited by Djin is most relevant.
And YES, this article claims that eight or more cycles at 3-week intervals is better (overall survival, prostate cancer specific survival and PSA decrease). Unfortunately, peripheral neuropathy was a common side effect.

More in general, docetaxel chemo is very tough on the patient and I wish your Father the best.

Post Edited (Sr Sailor) : 2/4/2021 6:46:45 PM (GMT-7)

Hello, Reclineaholic ~~~

Checking back in with you, hoping your father is doing well with his TAXOTERE chemotherapy infusions.

I know you said he is in his early 80s, and had been on XTANDI.

I know his original PSA had been over 1000, but with treatments, his PSA went down to very low decimal levels. I admire his dedication to exercise and physical activity! Inspiring message to all of us to stay active.

I know your dad had received treatments at the Siteman Center in Saint Louis ---- highly respected treatment center!

Hope your father is rebounding after each chemotherapy treatment ---- and my hope is that he is seeing affirming results from his treatments.

Thinking of you and your father ~~~
CYCLONE ~~~ # Iowa State University

reclineaholic,

Best wishes to your dad from me as well. I am glad to read that my chemo diary was helpful.