Looking for paper on LU-177 following Xtandi

[Chugach]

I saw a post that Lu-177 following Xtandi was particularly effective. Can somebody send me a link to the paper?

Thanks

[GP24]

tango65 provided the link: healthunlocked.com/api/redi...

[Pommedubois]

wol-prod-cdn.literatumonlin...

I hope above link is helpfull. I had Xtandi until a month ago. However my PSA has risen to 7 and the next treatment might be Lu 177. I am in the Netherlands.

[JuanVV in reply to Pommedubois]

How long for was Xtandi effective in lowering PSA? My husband's been on it for three months, next week having new tests, will post results. Keeping my fingers crossed. He's had a lot of fatigue and shortness of breath, did you get these side effects?

[Pommedubois in reply to JuanVV]

About 9 months. I took it together with Zoladex. I continued with Zoladex and in addition 10mg Pretnisolon to no avail. Friday I have an appointment with my Oncoloog to discus the results of a recent CT scan and the PSA increase. And of course what next.

[JuanVV in reply to Pommedubois]

thanks and good luck with your next appointment.

[luvhealth in reply to Pommedubois]

You might want to consider checking out the Care Oncology Clinic which has some other options. Their website is careoncologyclinic.com/ and they will work with your current oncologist. My husband is currently using these other protocols since his Xtandi after 8.5 months failed in March of this year. We've learned that chemo doesn't help prostate cancer and that is all his oncologist recommends now.

[monte1111 in reply to luvhealth]

I believe chemo helped me a lot. To each their own. Enjoy.

[monte1111 in reply to JuanVV]

Xtandi 22 months for me, psa 0.1 Sudden 26 point jump in alk. phosphatase this month, so the ride may be over. Scans next month will tell the true story. Was taking 10 mg prednisone which I tapered off of and ended. Now have fatigue. Anemia caused by I don't know what. Extensive bone mets. Lymph node mets. Good luck.

[j-o-h-n in reply to monte1111]

Monte,

Let's hope and pray your scans next month will be A-OK.... I'm in your corner...

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 06/13/2019 5:11 PM DST

[j-o-h-n]

Didn't see any comment from you. Did someone answer your question?

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 06/13/2019 10:47 AM DST

[Patrick-Turner]

Hi Chugach,

I can't give you a link to any scholarly paper on effectiveness of Lu177 after Xtandi ( enzalutamide ).

But there is a trial going on in Sydney at St Vincents for Lu177 with Xtandi added for the whole time Lu177 is used.

I have just completed 4 x Lu177 treatments after Zytiga failed then Chemo failed, and Psa was 50 at end of chemo, Chemo as halted after 5 shots and 1 month after last chemo Psa halved to 25 which was when I began Lu177 last November 2018. I have completed 4 Lu177 cycles and Psa has moved from 25

before No 1 shot to 1.6 now, But right after No 3 Lu177, I was started on Xtandi because its supposed to make Pca tumours uptake more Lu177. Psa was 5 before No 3, and so Psa reduction over about 4 months is to 1.6 now, and the last PsMa scan compared my cancer images to those after 2 Lu177 shot and the radiologist mentions many bone mets have been hit hard, and nearly all soft tissue mets have disappeared.

So from chemo failure in October 2108 with Psa at 50, its now 1.6, and the amount of active Pca has been much reduced, with no new mets appearing.

In 8 weeks my condition will be reviewed and its highly likely maybe some Psa rise will occur, and the doc who is giving me Lu177 said that he may consider 1 shot of Ac225, all very doable at the same Sydney hospital where Lu177 is presently administered. Usually, Ac225 is a much stronger acting type of nuclide than Lu177, which is fairly genteel but has good effect on soft tissue mets such as lymph nodes but less effect on bone mets. The Ac225 acts on all mets, but may cause more side effects of dry mouth and dry eyes. Several Ac225 will cause irreversible dry mouth & eyes. But one shot may not.

I've had 4 x Lu177 shots and had only temporary dry mouth after each shot but its now 5 weeks since 4th Lu177, and I'm getting a dry mouth sometimes at night and maybe the side effect begins to become permanent in weeks after treatment. OK during each day.

I had a lot of EBRT to PG originally in 2010, and after first 2 weeks I found passing water was quite painful, then that stopped within 2 weeks after completing 35 radiation sessions over 5 weeks. But 18 mths later I began to bleed a bit from rectum, maybe once every week maximum, and that lasted about a year. I knew man who bed a 1/2 cup of blood every day, and we all will have a slightly different side effect outcome. I have a sore hip, and maybe EBRT going through soft tissues to get to PG have damaged hip joint cartilage. My doc give Lu177 said that the reason I now have pain could be due to having EBRT in 2010. Many men would have died by now from Pca, nearly 10 years after diagnosis. So in 2010, there was not a big concern about how EBRT affected hip joint tissues, Besides, there was no other external beam radiation machine in town able to fire the high power X-rays at angles that would avoid passing through my hip joints. The docs said it all would be OK and work to kill my Pca cells in PG but 2 years later I found the Pca in PG was very much alive, and EBRT had done little. and ADT was the main agent of Psa reduction. My Pca was radiation resistant to X-rays.

But I am alive and fairly well now, all things considered. It seems my Pca was not resistant to the beta - alpha particles from Lu177, ie, the Lu177 is like having a local and well targeted miniature and slow exploding Atomic Bomb onto where Pca tumours are located. Overall, the immediate Lu177 side effects are very tame and tolerable compared to Docetaxel which is still having effects 8 months later, with my walking gait becoming a shuffle. I had both knee joints replaced in Feb 2017 when Psa < 1 while on ADT + Cosadex. This meant that there was much tender healed tissue in my legs, and the chemo would have affected my body's repair work. May have affected my hip cartilages. However, although my scans show I do have arthritis, I have less pain riding a bicycle than walking, and day before yesterday I managed 5 km very easily, so I think maybe my hip pain is due to some other soft tissue damage in the hip joint area, something to do with tendons or muscles.

I have yet to arrange a second opinion on just what is causing hip joint pain because the orthopedic surgeon I went to last week seemed unable and unwilling to describe things mentioned in radiologists report for the MRI I had done for the whole right hip joint area. If you don't get answers then keep trying with someone else until there is somebody is able to explain ALL things. I might be quite OK for 5 years without a hip joint replacement. I could hardly walk before having both knees done, but I cycled 200km before the double knee joint operation!

I see my local general practitioner GP soon, and maybe he gives me a referral to a bright eyed 40 year old doc who won't mind explaining all things and might know of a suitable oncologist-orthopedic doc who specialises in fixes for ppl with bone troubles with cancer present.

My low Psa after the 4 x Lu177 gives me hop I might last 5 years before Nature insists that my expiry date has come, and that my conscious mind will simply un-exist, and my atoms will be recycled for some others to borrow for their lives.

I have really no idea how long I might last, but after being diagnosed with Gleason 9, inoperable, despite Psa > 6, I have always thought I might only have 2 years left, because I have seen some men die 3 years after diagnosis and their Pca hardly responded to anything, or else their Pca rapidly grew when treatments were given, ie, their Psa rapidly increased when Cosadex or PARP agents were used. There are a % of men who are very unlucky, and doctors have very little effect to lengthen their lives, but so far, I have been fairly lucky to get a fairly good response to Lu177, and my general condition will allow more future treatments. I'd be a fool to refuse anything, because then I'd more likely reach palliative care sooner rather than later.

The fight must continue.

But for now, I don't have to worry for a couple of months.

Its winter here, the Xtandi might make me a bit more sleepy, so OK, I try to hibernate more, the body tries to heal itself while sleeping. But I am wide awake and alert for most of any day. So, I am alive to enjoy the wonderment of life for a bit longer, and I should enjoy next spring.

So I hope you also get some relief from medical treatments.

Patrick Turner.