cart t therapy or lu177

[Eabradley]

age 41,dxjan of 2018. zytiga beginning to fail. psa up to 7.5 from 3. psa at dx was 1250. lots of mets. looking into the vision trial at Northwestern and a cart T trial at City of Hope. there is also a trial at U of Chicago with Nivolumab and Rucaparib. this is a phase 1 but i know it is being tested elsewhere but cant get any results. any information on any of these approaches would be great. we have meetings scheduled to go over them in the next two weeks. the advice and support on this site has kept me going. thanks to all who take the time to do all the research and then the time to answer all these posts. maybe we dont say thank you enough.

[Fairwind]

Cart-T or Lu-177.........Which ever one shows the most promise. That will be up to you to determine..One word of caution..Getting into these trials can be frustrating and difficult. Lots of backstage politics involved. I finally made it into the Lu-177 "Vision" trial but it took 6 weeks. Lots of hoops to jump through, lots of hidden expenses.. So always have plan two in place in case plan one does not work out...Have you had any chemo ? That's a requirement to get into the "Vision" trial...

[Eabradley in reply to Fairwind]

thanks again for taking the time to reply as it seems like you are starting lu 177 tomorrow. you are in my thoughts and prayers

[Tall_Allen]

You have already had docetaxel? What did the analysis of your tumor biopsy show?

[Eabradley in reply to Tall_Allen]

12 rounds of chemo. tumor biopsy did not show anything.

[Tall_Allen in reply to Eabradley]

In that case Nivolumab and Rucaparib have less chance of efficacy. Between the other two, you have to think about exclusion criteria and sequencing - if you start with CAR-T, you may be able to go onto the VISION trial after a shorter wait. I think VISION may preclude CAR-T.

[Olivia007 in reply to Eabradley]

The chemo didn’t lower your PSA? everyone claims it does wonders so I wonder and my dad wonders if he should do chemo at 81 years old?

[Tall_Allen in reply to Olivia007]

I don’t think that an anecdote on a website is a good way of making a decision.

[Olivia007 in reply to Tall_Allen]

I'm not making a decision based on an anecdote. I'm just wondering and weighing the pros and cons. Yes of everything I read I'm not that stupid.But I really don't feel very secure with my dads urologist either its almost as bad. One minute he says the scans show bone mets I suggest radiation he says why would we radiate a bone that doesn't have cancer? I read the radiologist finding and they cant say its 100% bone mets or cant exclude arthritis? So what are we 100% sure of other than his prostate biopsy and a high PSA so the scans may just be arthritis?

The urologist tells me and my dad stop zytiga and prednisone and I call my dad 2-3 times a day to check on him he was complaining he had all these different side effect symptoms and yes I dr. googled it and it said to taper off I called the urologist told the tech what was happening she talked to the doctor and she said he told us to cut back to half then a quarter I said he's lying I hang on to every word he says and he never gave us those instructions. It shocked me how he lied and my poor dad had these horrible cold turkey symptoms

I have an oncologist appointment set up for October I sure hope he has answers. Sorry I'm fed up with doctors its all about money and no clear cut answers my dad is sick of them too he wants to stop going period. I dont blame him either.

[tango65]

I would try Lu 177 PSMA treatment first since it is a treatment proven to work for many patients with advanced prostate cancer. If you had many bone metastases you could consider the Ac 225 treatment trial :

clinicaltrials.gov/ct2/resu...

Ac 225 PSMA could be more effective than Lu 177 PSMA if there are many bone metastases and infiltration of the bone marrow.

I am no sure, but I believe there are not data showing that CAR-T cells therapy works for prostate cancer. I understand that CART-T cell therapyy could have severe negative side effects.

[Fairwind in reply to tango65]

This phase one trial in just one location seems pretty risky. Curing your cancer is not the goal..Seeing how sick you get from the drug is the goal..

"This is an open−label, single−center Phase I dose escalation study designed to determine the dose−limiting toxicity (DLT) and the maximum tolerated dose (MTD) of 225Ac−J591 in a single dose regimen."

[tango65 in reply to Fairwind]

I would try the Lu 177 PSMA first. There is not other way I know of to getting Ac 225 in the USA.

[middlejoel in reply to Fairwind]

Fairwind, Are the guys that participate in such a trail told upfront what you have written? I can't see why anyone would agree to participate in such a trial

[Eabradley in reply to tango65]

much to consider. looks like the the act225 is also phase 1 to determine the dosage level..will go over it all .. thanks

[tango65 in reply to Eabradley]

Best of luck.

[Longterm101 in reply to Eabradley]

How is your son doing ??

[abmicro]

Immune therapy has not shown very much promise with prostate cancer. LU177 and other radiotherapy trials are showing good results. Check if Cart T immune treatment will disqualify you from LU177 or Ac225. If not, cant hurt doing Cart T first, then later LU177 or Ac225. After that, you can still do Radium 223, an approved treatment covered by medicare. You will be disqualified from most radiotherapy trials if you did more than 1 full round of chemo treatments, so plan chemo accordingly.

I was able to get LU177 trial, but perhaps I should have gone for the Ac225 because all my tumors are bone related. I am hearing that the Ac225 might have worked better. I did not plan well.

[nobaday]

How long have u been on Zytiga? Switching from 5mg prednisone to 0.5mg dexamethadone could extend the life of Zytiga. Search dexamethasone switch and u should find more info and a link to a good research document.

Good luck!

[j-o-h-n]

To Eabradley, I pray you get into the right trial that would bring you health and joy (and your Mom also)...

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 07/26/2019 6:29 PM DST

[Patrick-Turner]

If I were you I'd get Lu177. But for that you need to have a PsMa Ga68 PET/CT scan to see if you are suitable for Lu177. I've been fighting Pca since 2009, at 62yo, when Psa was only 6, and it went up to 50 last year after chemo failed.

I then began Lu177 last Nov, PsMa scans showed it should work, and I had 4 shots between Nov 18 and May 19, and Psa is now 0.7. No more bone pains.

Those other things you mention could be done after Lu177.

But I guess costs and travel to where things are available are your concern.

Here in Australia, I could buy Lu177 for usd $27,000 and during no 3 and 4 shots there were men from US who flew over to get it.

Patrick Turner.

[Leader4077 in reply to Patrick-Turner]

Followed your Lu-177 journey started 3 years ago in AUS. How are you doing now?

Mike

Seattle

[middlejoel]

Eabradley,

Who is your MO at City of Hope?

Joe