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Jevtana (Cabazitaxel) PBS approved in Australia after docetaxel chemo fails


JimJimJimJim

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JimJimJimJim

Jim Marshall (not a doctor) said ...

One scenario for advanced prostate cancer treatment is:

Primary treatment - one or more of:

  • surgery,
  • radiation,
  • primary hormone therapy (ADT))

Recurrence treatment - one or more of:

  • radiation,
  • primary hormone therapy (ADT),
  • secondary hormone treatment

Castrate resistant treatment:

  • chemotherapy

Chemotherapy resistant treatment

  • other agents like Zytiga (abiraterone acetate), not yet PBS approved in Australia.

(This is just one scenario. There are many different prostate cancer treatments. There are many different combinations and sequences of these treatments.)

Chemotherapy

The first chemotherapy used is often Taxotere (docetaxel). It gives some patients some extra survival time with a reasonable quality of life for most of them.

If you do not respond to docetaxel initially, or it fails after some time, Jevtana (Cabazitaxel) can be used. It too gives some patients some extra survival time with a reasonable quality of life for most of them.

Another chemotherapy agent sometime used is Novantrone/DHAD (Mitoxantrone (sometimes spelt mitozantrone)). It has not been reported to extend life, but can give many patients a greater quality of life.

[Addendum: Novantrone/DHAD (Mitoxantrone (sometimes spelt mitozantrone)) did extend life significantly if given with Combined Hormone Blockade (CAB) to men with locally advanced disease as the first treatment in a small study of 38 men.

CAB = an LHRH agonist like Lucrin or Zoladex + an antiandrogen like Cosudex or Flutamide.]

We previously reported that Jevtana (Cabazitaxel) is not on available to most men in Australia.

Thanks to Euan Perry's vigilance on drug approvals, we can now report that Jevtana (Cabazitaxel) is now available in Australia on the PBS (Pharmaceutical Benefits Scheme).

The conditions for your doctor's prescribing this are listed below.

... end Jim

From the PBS website:

Jevtana (Cabazitaxel) may be prescribed for:

Treatment, in combination with prednisone or prednisolone, of castration resistant metastatic carcinoma of the prostate in a patient who has failed treatment with docetaxel due to resistance or intolerance and has a WHO performance status of 2 or less.

Note

Patients who have received PBS-subsidised cabazitaxel are not eligible for PBS-subsidised docetaxel.

Patients who have progressive disease on cabazitaxel are no longer eligible for PBS-subsidised cabazitaxel.

LHRH agonists include Zoladex (Goserelin), Lupron (leuprorelin), Eligard (leuprolide), Lucrin (leuprorelin acetate), Suprefact (buserelin), Suprecor (buserelin), Synarel (nafarelin), histrelin (Supprelin), Suprelorin (deslorelin), Ovuplant(deslorelin), Triptorelin

Antiandrogens used in primary hormone therapy include Cosudex/Casodex (bicalutamide), Anandron (Nilutamide), Nilandron(Nilutamide), Eulexin (Flutamide), all nonsteroidal, and Androcur (Cyproterone, a steroid),

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When hormone therapy fails (ADT) and you move on to Taxotere ect. do you remain on ADT during the Chemotherapy Treatment?

Nev

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JimJimJimJim

USA medical oncologist Stephen Strum is quite clear on this. You should continue.

In this paper, Lee and colleagues found in a small sample that it did give you longer survival, but not significantly:

http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=64&abstractID=20280

If you wish a lot more information, try

http://www.hrpca.org/FAQ.htm.

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