Actinium after Lutetium-177
I've had my two doses of Lutetium without great results. Last treatment was about two to three months ago. I got a call from Dr. Tagawa's office at Weill Cornell and he wants to see me to see if I'm eligible for the Actinium trial. Has anyone here moved on to Actinium after receiving Lutetium?
I am a big fan of Scott Tagawa, and I think Ac-225-PSMA-J591 is probably the best of the radiopharmaceuticals currently in clinical trials.
pcnrv.blogspot.com/2016/12/...
Thanks Tall_Allen...your picture looks familiar. Have you been to Weill Cornell? I'll let everyone know what happens because right now I have nothing but questions.
I live in L.A. I've never met Scott Tagawa in person, but I've traded emails and talked on the phone beginning 4 years ago when he was doing his first clinical trials about Lu-177-PSMA-J591 and I wanted to tell patients about them. He has been very informative and has regularly instituted important clinical trials.
Yea I agree...it's a 13 hour trip for me to see him, but I was convinced after our first meeting.
Actinium 225 is a "stronger drug" than Lu-177. It also has more side effects than Lu-177 (e.g. dry mouth). I would try it, it usually helps if you have bone mets.
AC-225 is a higher energy alpha emitter. It releases more energy per unit of linear dimension and has more potential to break both strands of DNA if it hits the cancer.
I think that seeing Dr. Tagawa is an excellent idea.
The radionuclide treatments like Lu-177 and Ac-225 typically have two components. There is a molecule of a monoclonal antibody. An "antibody" is a molecule that precisely fits (physically and electrically) to another molecule, an "antigen" like lock a lock and a key. "monoclonal" means that the antibody only fits one particular antigen, for example prostate specific membrane antigen (PSMA), a molecule often found on the surface of prostate cells and uncommon anywhere else.
The other component is a radioactive atom, like Lu-177 or Ac-225. That is "bound", i.e., chemically bonded, to the antibody.
A solution of this combined molecule, antibody and radioactive atom, is injected into your blood stream. It gets pumped by the heart all around the body and, where it encounters the antigen, it stops and binds to it. What doesn't get bound to a prostate molecule in this way will, hopefully, pass out of the body in urine before it can do much radiation damage anywhere else. But the molecules that are bound to the prostate antigens stay with the prostate cells (presumably tumor cells) and, at some point, give off some radiation as they change state from one form of atom to another. The radiation they give off is right at the tumor cell and they can damage or kill them.
So, given all that, the main issue I would expect to bring up with Dr. Tagawa is, why might his treatment work better than the Lu-177 treatment? Does he think that you didn't have enough PSMA to attract the treatment molecules, or does he think the antibody wasn't specific enough to find it all, or does he think that the radioactive atom wasn't radioactive enough to kill the tumor cells (gregg57's point), or does he think that you have a better target than PSMA in your tumors?
I'm guessing he's got some pretty specific ideas about these questions and can say something that will help you understand the new treatment and his explanation of your chances of it working.
Please let us know what you learn.
Best of luck.
Alan
Hi. Would you be able to update us about your eligibility for Actinium trial please?
Thank you
Hi Cladius...I received my first and only treatment 12/20/18. I won't know much about any results until 1/03/19 and that won't tell the whole story, but hopefully give me some idea.
Have you checked for BRCA2 mutation?
Quite possibly, cause poor reaction to Lutetium.
researchgate.net/publicatio...
Radium 223 relations to BRCA2 is being studied extensively.
Hopefully Alpha Particle (Ra 223, Act 225, Thorium) behaves differently than Beta Particle (lutetium). europeanurology.com/article...
I have been checked...negative
Hi wrando,
When you have a chance, can you please update your status after your first Actinium cycle?
I know someone who had 4 Lu177 cycles. The first two worked very well and PSA was reduced 75%. The third and fourth cycles didn't work at all. Worse, PSA goes up again and is around 65% of the PSA before the first cycle. His doctors said he is radioresistance to Lu177.
If Actinium works after Lu177 failed, it brings hope to him (and many other people).
Quyen
I didn't receive much or anything from the LU-177 trial. The Actinium trial consists of one treatment which I received almost three weeks ago. So far my blood work shows my PSA doubling in two weeks 740 to 1560 and some side effects...extreme fatigue and nausea. I did have a pretty potent flare response a couple of days after the treatment. This is all I know at this point with the exception of some decrease in pain at some met sites.
In his case for the first 2 cycles, PSA went up around 20% three weeks after Lu177 infusion, then started coming down. As you received Actinium three weeks ago, I hope PSA will go down in your next test. Fingers crossed.
Also, when Lu77 worked, his pain was increased right after the infusion and then decreased after 2-3 weeks.
BTW I can't rule out a transfusion at some point as the Actinium is tough on the blood counts...except PSA
I have just gotten my numbers back 8 weeks from start of treatment. All numbers going the wrong way...this was another bust for me. I won't do chemo so I guess I'll just ride it out from here. I still owe them scans and will honor it if I'm able. I wish I had something better to report for me and you.
any chance you can supply Dr. Tagawa's contact details? we live in the Uk where neither Lutetium 177 or AC255 are not available so we will have to pursue Germany but haven't a clue where to start so any help greatly appreciated. Thank you
many questions about Actinium 225 
Lu177 versus Actinium in Germany or in India. I need advice.
Has anyone had Actinium recently
