Radium 223 for micrometastasis treatment in patients with BCR.|
ccr.cancer.gov/news/article...
clinicaltrials.gov/ct2/show...
Xofigo is radium 223 but Xofigo is indicated and approved for the treatment of patients with castration-resistant prostate cancer, symptomatic bone metastases and no known visceral metastatic disease..
I always wonder if it was possible to do the same with Lu 177 PSMA or Ac 225 PSMA, but they do not treat unless there are metastases.
I hope this approach works.
Lu177 does not work all that well with bone mets, better add Ac225 to it for that. I guess they should add another arm to this trial and treat with a mix of Lu177/Ac225 instead.
I read: "This study will help investigators understand the treatment’s effect on men with micrometastatic PC that is too small to be detected with standard imaging,"
Getting a PSMA PET/CT to evaluate these patients will probably be more beneficial than the NaF PET scans they plan to use.
I will nice if it works. There was a trial for adjunctive short of chemo after primary treatment designed to do the same; however, there were not enough participants and several trials closed without results. I thought that there was merit; however, I understand that insurance companies were not on board.
GD
This is a clinical trial at NIH. These trials are completely free. You have to pay for travel and lodging and living expenses, but NIH refund the air fare and give a token amount around $ 50 a day for living expenses. I hope they can do it and it works and people can delay ADT and the trip to castration resistant cancer.
I know Dr. Madan (the PI) personally. I have communicated with him several times and I have a very good impression about his knowledge and interest in the patients.
It will be more interesting if they could do Lu 177 and Ac 225 PSMA and see if they can treat micrometastasis in bone and soft tissues.
Best of luck!!
Damn shame that this study is so far away from me... it sounds like just the thing ( if it worked) to keep me off ADT. I’ve been dodging ADT with a PSA doubling time well in excess of 6 months for a long while along with negative Bone and body scans.... figure my luck will run out about this December given PSA trends.... WhatEVER they can come up with that would make ADT unnecessary would be a BIG win for the treatment community.... well, at least some people are thinking in this direction’
Perhaps you could qualify. Check inclusion and exclusion criteria. The trial is recruiting.
clinicaltrials.gov/ct2/show...
Best of luck on the journey.!!
Problem is the location... more than 7 hours away... too many home responsibilities living by myself to comply with all their requirements///. I’ll be keeping an eye on the results of this one however.... glad to see someone thinking in this direction....
I hope it works and it could lead the way to treat the so called micrometastases with Lu 177 PSMA and Ac 225 PSMA which are able to detect PSMA in a cancer cell. They do not use these PSMA ligands unless they can see the metastases (4 mm or greater in diameter). The PSMA ligands could treat bone and soft tissue metastases which is a difference with Ra 223.. This game to wait until metastases can be seen it always seemed foolish to me.
Can someone join this trial if they are still castration sensitive and dont have clearly visible mets even though metastasis is the diagnosis/PSA 38 before ADT/Lupron started 4 years ago?
If you had metastases in a bone scan or ct scan. I believe you will not be accepted. You should write to:
amy.hankin@nih.gov
She is the coordinator of of the trial.
Interesting trial, I noticed one of the exclusion criteria is prior chemo, so it looks like this could be an alternative to docetaxel if it works.
I believe they are looking for patients with BCR after RP or radiation, without ADT (testosterone has to be higher than 100) or any other treatment, who have suspected bone metastases in PET/CT 18F NF and it seems other PET/CTs since they will accept patients with suspected metastases in lymph nodes to see if there is an abscopal effect.
Yes, was thinking I could qualify if I had BCR post HDR-BT/IMRT a few months after stopping ADT if T recovers over 100. If it works, would be a good alternative to chemo.
Patients with a PSA doubling time of 5-15 months in the nih study. I dont fall in that range. Im faster than that.
Patients with a PSA doubling time of 5-15 months. I guess they figure it's a waste of time if doubling time is less than 5 months.
Xofigo Radium 223 Dichloride 
Now going into clinical trials for specific types of cancer, Alpha Tau’s technology shows potential for treating any solid tumor. 
Prazosin vs. Doxazosin for Prostate Cancer Inhibition
Glucocorticoids & Bone demineralization.
According to PSMA PET Scan all metastases found are in bones; so after discussion with Oncologist about options, Xofigo (Radium-223) is next
