LU177 with XTandi - Postrait Cancer

[mab84]

Hello, my father age 75 ,has PSA of 4500 , tried unsuccesful hormone therapy . We have recently given first doze of LU177 PSMA. My concern is should we continue daily doze of Xtandi after LU treatment? Any benefit of hormone therpay with this? Furthermore due to his weakness we have never tried Chemo.

[Tall_Allen]

If his doctor didn't tell him to stop taking Xtandi, he should continue.

[GP24]

It seems to be possible that Xtandi increases the PSMA expression and supports the Lu177 therapy this way. I would continue to take it.

[mab84 in reply to GP24]

Thanks , have you experienced it yourself? What are the additional benefits?

[GP24 in reply to mab84]

I wrote: "It seems to be possible ...". This is just pre-clinical research. E.g. this study:

pnas.org/content/108/23/957...

Citation:".... antiandrogens up-regulate PSMA expression." In this study they used MDV3100 which was later renamed to Xtandi.

[Shooter1]

Much of his weakness may come from full dose (160 mg) of xtandi. That dose alone make me and invalid, lower dose and I could survive.

[tennis4life]

Confirming GP24's comment....Dr. Baum from Theranostics Center, Bad Berka, Germany states that "Xtandi increases PSMA expression" and is synergistic with LU 177 therapy.

[AureaF in reply to tennis4life]

What about Zytiga? Is it also synergistic with Lu-177?

[tennis4life in reply to AureaF]

My understanding is that Zytiga is synergistic with the therapy if you are taking it at the time of the therapy. I only have one correspondence with Dr. Baum so I can't comment on any other medication. Your father's doctor should certainly be the one to speak with since he is providing the therapy to your father.

[mab84 in reply to tennis4life]

Thank You!

Yes Xtandi + LU 177 treatment working out so far for my father. I dont know how long we will benefit from it but important is that his quality of life is improved a lot.

How is everything at your end?

BR

[Dominos7]

Same boat as we are in we are hoping for referral from MO for lu-177 this week my uncle is currently on Xtandi. Xtandi is well tolerated with radium 223 so we are hoping there is no overlapping toxicity with lu-177..

[mab84 in reply to Dominos7]

Dear Dominos7,

How is everything at your end?

Is LU 177+ Xtandi working out for you?

BR

[Jackpine]

I’m also on LU177 and continue on Lupron but they have stopped my Zytiga but only because it was not working anymore

I would ask your ONC but I’m sure he will want to continue all meds.

[Carmen2]

My comment will only confirm all the others you have received. My husband is in a trial for lu 177 and we were told that Xtandi increases the Pisa expression soon the cell surface.

Hope the lu 177 works for him.

[mab84 in reply to Carmen2]

Thanks , How much PSA has decreased after first doze? Also any complaints related to low red blood cells?

[Patrick-Turner in reply to mab84]

I am having my No 3 Lu177 shot in 10 days, and after 2 shots the Psa came down from 25 to 17, but all the many mets in soft tissues in thorax are now invisible to my last PsMa scan, and 4 out of 5 painful bone joints where the biggest of many bone mets are have lost all pain. Only one hip is now giving trouble and maybe after 4 x Lu177 I get a fix that lasts some time. But the Pca and its treatment in a hip may leave my hip joint in a mess and its doubtful I could get a replacement hip joint so I could be crippled, and have to use a mobility scooter to get around. 7 weeks ago I cycled 1,000km in 3 weeks, and felt very well but now cycling hurts my hip, but I can walk enough right now to do the work around the house.

But what often happens when ppl get some treatment, there is a complication that springs out of nowhere. In my case it looks like my hip. Its possible it was due to fail and now it is, but could be due to Pca, but until I get an MRI I just have no idea about how to fix this complication, or if its possible. I'm 71, dx in 2009, Gleason9, in-operable, ADT continuing, Cosadex, extra "salvation" IMRT to PG, Zytiga, 5 chemo shots, and now Lu177. I am very healthy except for the stage 4 cancer.

So good luck, but we can only get what is available, and most things do not give a lasting fix with Pca, and cures are extremely rare.

Patrick Turner.

[mab84 in reply to Patrick-Turner]

Hello Patrick,

Hope you are doing well by now.

My father has received 03 doze of LU 177 along with 02 tablets of Xtandi. PSA went down from 4600 - 18. Doctor has suggested to wait for further response and also suggest to stop Xtandi .

He is doing better but we may argue with Doc for Xtandi . Also we may plan for 4th doze depending upon his condition .

Remember in Prayers!

Abdullah

[Patrick-Turner in reply to mab84]

Don't try to stop treatment too early. With initial Psa at 4,600, there is a lot of Pca to try to kill, so I would have 4 x Lu177, and maybe 5 if needed.

Xtandi is supposed to help Lu177 work better, and after Lu177, Xtandi keeps working. Maybe all this treatment seems to cost a lot of money, but as we age we must spend more on doctors to stay alive longer.

I had Psa 25 before Lu177 and some bone pains, but 2 months ago Psa was 0.4 after 4 x Lu177 + Xtandi, which I am continuing. I had Psa test yesterday and I see oncologist on Thursday next to see how I am going. It is always possible Psa is now rising, but now I feel well.

I cycled 230km last week.

Maybe Jesus and Allah are being kind...….

But Nature is in charge......

Patrick Turner.

[Carmen2 in reply to mab84]

Sadly, my husband has not had a strong response to the lu 177. After 3 treatments that went down a little, the last one went up. The red blood count is down a little but not much. No major side effects. It is a walk in the park compared to chemo from my observation. Jackie had a fantastic result in it.

[The_Don5 in reply to Carmen2]

Sorry to hear that was his psma scan avid ? i.e. was his body producing lots of psma at time of scan?

[Ldb01]

My husband is on Zytiga, that was the Ocologist’s last suggestion of treatment. Determined not to give up, we got hubby registered on ac ACT 225 trial. The professor was happy for him to stay on Zytiga and taking the layered approach treatment. His PSA dropped from 48 in December to 9 in March. Both Professor and oncologist very happy. The University did one PSMA scan with the Gallium tracer. They will do another scan in May to make a comparison in the bone mets.

[mab84 in reply to Ldb01]

Hello Ldb01,

How is everything with your husband? He did not try LU 177 before ACT 225 ?

BR

[Ldb01 in reply to mab84]

Hi mab84, its been a rollercoaster. When he started the trial, they claimed Lu did not work. There is one patient who did it and has now continued with ACT. A month ago, Zytiga was restarted as well. His PSA has dropped from 48 to 35. Blood cells a bit low but other body functions are all fne. Has experienced more pain than ever but he is on a combo of pain pills that are helping. Weight loss is hectic and eating is a problem. Are you on Lu ?

[mab84 in reply to Ldb01]

Hello,

Yes on combination of both . LU + Xtandi . Clinical conditions and blood vitals are under control so far.

[Ldb01 in reply to mab84]

Please keep us informed on how it goes.

[The_Don5]

jnm.snmjournals.org/content...

"Additional treatment with newer antiandrogen agents Abiraterone or Enzalutamide probably has a synergistic effect in combination with Lu-177 PRLT. PSA response after PRLT predicts a longer OS. Previous chemotherapy (1st or 2nd line) and Ra-223 treatment were associated with a worse prognosis."

[The_Don5]

we are currently taking both the above.

[mab84 in reply to The_Don5]

Hello ,

How is your experience with LU 177 + XTANDI going on ? I am just confuse with fact that alone XTANDI not working how combination will benefit. Is it only LU -177 or combination?

BR

[ToniTbird]

Is everyone in a clinical trial for this treatment or has anyone gone overseas?

[Ldb01 in reply to ToniTbird]

We live in South Africa and my husband is on the ACT 225 trial at our university of Pretoria. There have been some foreigners from Australia who have travelled here for the treatment.

[u302000]

mab84,

Would you consider sharing your experience prior to and with LU-177 treatment?

healthunlocked.com/advanced...

Cheers,

Buddy