PSMA treatment equal

[Blair77]

Hi,

I’ve researched different options for LU 177 and see it is offered in Germany, Australia, Israel and even in India. Does anyone have knowledge of one location would be superior to another?

Thanks for the help!

[Tall_Allen]

My top pick is Heidelberg - Uwe Haberkorn - they invented it and have the most experience. Close second is Munich - Matthias Eiber. They are using a ligand (I & T) that may be less toxic. Bad Berka is a good choice too. It may be less expensive in India or Australia. South Africa also offers it. I did not know Israel does, but you may want to wait until they have more experience.

[MoleyMoo in reply to Tall_Allen]

Uk use I&T ligand as well - based in Windsor our of London

[cesces in reply to Tall_Allen]

The I&T ligand is sort of important as it should avoid renal and salivary damage.

Do they now have sufficient experience with it that it's ready for prime time?

Is there any reason not to favor it over the other ligands?

[Tall_Allen in reply to cesces]

Bad Berka and Munich have several years of experience with it. I imagine Heidelberg as well.

pcnrv.blogspot.com/2017/09/...

[immunity1]

Probably not a lot in it between Germany and Australia (theranostics). Both have used same reagents (I&T), dose,for over 3 years with hundreds of patients. Choice could be an issue of logistics and price. Do it early.

[cesces in reply to immunity1]

Where exactly in Australia can you get the I&T ligand?

[bobdc6 in reply to cesces]

theranostics.com.au/lutetiu...

[cesanon in reply to bobdc6]

Thanks

[Hidden]

Here are 2 articles about I&T ligand with LU-177.

jnm.snmjournals.org/content...

urotoday.com/conference-hig...

[immunity1]

From my understanding there is no meaningful difference between the efficacy of ligands 617 and I&T for Lu177 therapy. =Rob

[cesanon in reply to immunity1]

Somewhere, maybe on tall allen's blog I saw that I7T was maybe not so good for diagnostic scans.

There is also the issue of Chelation. Some ligands are not so good at hanging on to the active molecule. Those that aren't can have some troubling side effects.

I remember at a conference one of the Docs was comparing the different ligands. And they could tell which ones would hang on the best. I think some of them have 2 molecular hooks and some have 3. The ones with 3 were much better at hanging on.

I wish I know which I&T is.

[immunity1]

Sorry I cant comment on theoretical differences which could be important between the 2 ligands, and don't have time to explore. My comparison (some years ago) was based mostly on early Germanic trials looking at actual binding studies for PSMA diagnostics, but presumably Lu177 therapy as well.

[AlanLawrenson]

My brother had 4 doses of Lu177 -617 vi a Theranostics Australia. Excellent uptake and PSA below 1. Sadly, about 8 months after last injection, his PSA went from 1 to 100 to 315 to 740 over about 8 weeks. I understand many other J617 patients have seen this type of aggressive PCa activity. My brother had SBRT on spinal lesion: result: he has paralysis of one leg. Now in rehab hospital and again on Xtandi.

I believe the J591 ligand offers more LT promise. 40.3 month OS in a trial vs 14.3 months on J617. See AGM presentation od Telix Pharmaceuticals, (TLX) - an ASX listed company.

[Rexwaterbury in reply to AlanLawrenson]

These are the reports that really worry me. Does anyone know how often this happens?

[AlanLawrenson in reply to Rexwaterbury]

The problem is it's still early days on the Lu177 journey. Numerous trials are ongoing with multi-therapies. Results of the Vision trial out next year will be revealing.

I'll be doing a separate post later today on Veyonda, a new drug that will be recruiting for Phase 2 trial in USA, Oz, etc. next year.

[paritosh1010 in reply to AlanLawrenson]

that psa progression is truly scary.

[AlanLawrenson]

Yes, it is. He is being transferred to another medical facility tomorrow. Will meet with his medical team after they do latest blood chemistries. They stopped Xtandi three days ago. Why? unknown, but probably due to poor blood results.