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Jim Marshall (not a doctor) said ... If you have castrate-resistant prostate cancer, common treatments that your doctor may add to your regular ADT treatment include: Docetaxel (Taxotere) Enzalutamide (Xtandi) or Abiraterone (Zytiga) Cabazitaxel (Jevtana). But what are your doctor's drug choices when the cancer is no longer under control after all three options? If you responded to docetaxel, your doctor knows you may well respond again to another dosing of docetaxel. But this increases your risk of side effects - especially peripheral neuropathy or nail disorders. Thibault and her colleagues looked at the possibility of giving cabazitaxel another go. They report a benefit to men - 34.3% improved, and 47.8% remained stable. Peripheral neuropathy: nerve damage to hands and feet. Castrate-resistant prostate cancer: PSA going up, even though testosterone is very low. ... end Jim The full article can be found in the European Journal of Cancer 2018: http://www.ejcancer.com/article/S0959-8049(18)30725-1/fulltext which reported the following Results and Conclusions: Results A total of 69 of 562 patients (Eastern Cooperative Oncology Group performance status 0–1 69%) were rechallenged with CABA (25 mg/m2 q3w, 58%; 20 mg/m2 q3w, 27.5%; other, 14.5%) for 1–10 (median 6) cycles; 76.8% received prophylactic granulocyte colony-stimulating factor. Median radiological or clinical PFS with CABA rechallenge was 7.8 months and 11.9 months with initial CABA therapy. OS was 13.7 months (95% confidence interval [CI]: 9.3–15.7) from the first CABA rechallenge cycle, 59.9 months (47.8–67.1) from the first life-extending therapy in mCRPC and 78.3 months (66.4–90.7) from mCRPC diagnosis. Best clinical benefit was improved (34.3%) or stable (47.8%). Lack of response to rechallenge occurred in 17.9% of patients (3.1% with initial CABA). The level of prostate-specific antigen decreased by ≥ 50% in 24% of patients at rechallenge (71% with initial CABA). There was no grade ≥III peripheral neuropathy or nail disorders. Conclusions CABA rechallenge may be a treatment option without cumulative toxicity in heavily pretreated patients with mCRPC who are still fit and had a progression >3 months after the last CABA injections.
Paul Edwards posted a topic in Articles on other sitesThanks to Chuck Maack for alerting us to this. A collaboration between leading US and British Cancer Centres has been described as a landmark study. Click on this link to read a report of the study. Chuck's comment This appears to be terrific news. The problem now is whether or not the researchers get fast-track funding to continue their research to determine which medications currently are correct for which genomic defects, and what medications are available and might be used singularly or in combination with other medications to go after the other genomic defects. Then…and we don’t know when…we are going to need government approval for coverage for the gene testing that will permit Medicare to cover that expense..... And (another) then, we will need FDA approval (in Australia, TGA approval) for those medications not yet developed/determined or approved for prostate cancer, but now necessary, as well as may need combining with other medications. So, it looks like now it will be a matter of time and how fast-track they continue this research.
Paul Edwards posted a topic in Articles on other sitesThe journal UROLOGY has published a number of online presentations by 5 leading medical oncologists and urologists looking at the new options for the treatment of patients with Metastatic Castrate Resistant Prostate Cancer. Whilst all of these presentations are of interest to men with advanced prostate cancer, the 2 roundtable discussions (Clinical Treatment and Patient Treatment) are especially recommended. Click here to view the presentations