Comments on: Predicting response to Taxotere chemotherapy

By: Sitemaster

Sitemaster — Sun, 29 Nov 2009 17:01:01 +0000

Dear Mr. Helms:

No. It would not be accurate to think that your survival after starting chemotherapy would be limited in this way.

In the first place, the 15 months and the 25 months mentioned in the study were “averages” for all the men with PSAHLs of above and below 70 days. You could easily do better (or perhaps not so well).

So … in the second place — such averages do not apply to individuals. Your personal response to chemotherapy (should you need it) will likely depend on (a) your personal PSAHL from the time you start docetaxel: (b) just how much your PSA drops from its level when you start docetaxel treatment; and (c) how long your PSA remains stable at or near the nadir (lowest) level it reaches.

Furthermore, with new drugs coming to market and entering Phase III trials all the time, it is more than possible that we will have better options for someone whose PSA starts to rise on first-line hormone therapy soon — so docetaxel chemotherapy may soon become a much later stage option than it is at present.

By: David Helms

David Helms — Sat, 28 Nov 2009 21:12:52 +0000

From this study and others, may I conclude that, considering a Gleason 9, RP with positive margins and lymph node involvement, subsequent 70 Gy of radiation treatment and LHRH Trelstar-LA (thus far for 6 treatments of an 8-treatment scenario) and with current PSA that seems to be stable at 0.02 ng/ml — if my PSA goes up and I need docetaxel treatment, my OS will be estimated at 15 to 25 months after beginning chemotherapy?

By: Sitemaster

Sitemaster — Mon, 16 Nov 2009 22:59:36 +0000

Dear Mr. Stein:

I am not personally aware of any prognostic data similar to that in the study above that could be applied to hormone-sensitive patients.

However, I can say that if your PSA has remained stable for approximately 20 months since your initial treatment, you have a strong chance that it may remain stable for an extended period of time. Of course whether this is a consequence of the surgery or of the chemotherapy or the combination is probably difficult to ascertain with any degree of certainty.

By: Ronald Stein

Ronald Stein — Mon, 16 Nov 2009 20:59:29 +0000

I have a Gleason 9 T3cN0Mx diagnosis. I had four treatments of Taxotere (one every 3 weeks) immediately after conventional RP (positive margins, seminal vesicle involvement — lymph nodes removed but clean). My PSA decreased from 0.2 to 0.1 ng/ml after the first treatment and 20 months later is at 0.05 ng/ml.

Are there any studies on Taxotere and hormone-responsive patients?

By: John Arnold

John Arnold — Thu, 12 Nov 2009 02:16:26 +0000

Good study! Part of what I’ve found the most perplexing and frustrating in my going-on-4-year dealings with advanced prostate cancer is the uncertainty of it all. Any time anyone pins down some aspect of it, they’ve won my admiration and thanks. Thanks also to the men who participated in this study. Your contribution is much appreciated, and will not be forgotten.