Jevtana failed, next Lutetium-177

[Shumaf]

Some update from my dad

diagnosed with advanced prostate cancer gleason 4+5 with bladder mets in May 2016. He had TURP, RT, docetaxel as first line. After the PSA started to increase he started Zytiga and had one year on it. He gets Turmeric since the diagnosis and since last month started to get BIRM as supplement.

He has stable PSA of around 1-1,3 but liver mets were detected two months ago. His MO proposed Jevtana and we did it. But after second cycle, the mets got slightly bigger, so no good response.

Now the MO recommends us Lu-177 as next treatment. He said it can be effective on liver and bone mets and may have less side effects than chemo.

Does any body have experience with Lu-177 effect on Liver mets?

What could be alternative or next treatment if Lu-177 fails?

[Hidden]

Carboplatin and Etoposide chemotherapy is often used to treat mets to the liver and/or other organs/soft tissues.

[Shumaf in reply to Hidden]

Thank you gregg. As far as i know the chemo drugs you mentioned are used for small cell cancer type. Is that right? I am not sure if it matches my dad's condition. I will confirm with his MO.

[Hidden in reply to Shumaf]

Yes, and the neuroendocrine variety is typically the type that metastasizes to the organs and soft tissue. An evolution toward this type of cancer often occurs from the pressure of treatment on the cancer. (treatment-related NEPC) This type of cancer doesn't express the PSA. There are blood markers that can be tested for such as Chromagranin A.

These are things to discuss with your doctor. Wishing you the best.

[Tall_Allen]

What country are you in? Where do you plan to go for the Lu-177-PSMA treatments? Be sure he doesn't take any supplements during treatment - they may interfere.

[Shumaf in reply to Tall_Allen]

I am in Germany. But my dad lives in Turkey. We found a hospital in Istanbul with a specialist in Lu-177. Tomorrow he will have the Ga 68 PSMA to see if he is eligible for the treatment. I will ask his Doc about the supplements. Thank you for the advice.

[Tall_Allen in reply to Shumaf]

If he can get in the Ac-225-PSMA-617 trial in Heidelberg, that may even be better:

pcnrv.blogspot.com/2018/01/...

[Shumaf in reply to Tall_Allen]

Is this a more effective treatment than Lu-177?

I guess the eligibility criteria is same, the positive result from G 68 PSMA. This we will consider for sure.

[Shumaf]

Thank you tango. I heard about this before. Is this a standard care any where in the world? I am not sure if we can find a place in Europe.

[acatalkaya in reply to Shumaf]

Merhaba; Lu-177 tedavisini yaptırdınız mı acaba ?

Have you try Lu-177 traitment ?

[ronnie1943]

Hi Shumsf, my husband has multiple liver small tumors. We are going to get the Lu77 shortly. His radiation dr. Said today...Why wait? We will have to travel out of state for the trial, but will be able to get all the infusions here in Philly at Jefferson. How are you going?

Sending wishes for good health.

Sincerely, Lynn.Pa