Next step!

[Vsahay]

My father has been on LU-177 therapy since March 2020.However, he had not taken the doses as per schedule(every 2 months) .As a result he got his 3rd dose on 6th Jan,2021.A month later he got tested(feb 8) and it seems the therapy isn<t working anymore. His psa has risen from 12 to 17 in the past one month and alkaline phosphate has risen to 350 from 180.

The doctor suggested him to take the next dose on time , that is in the month of March.He expects the psa as well as alp to decrease if the next dose is given on time and said that the decreased response might be due to delay in giving dose of LU.

What is the chance that he becomes reponsive to furthur cycles od lutetium therapy? What should we do next?

*NOTE- The patient is asymptomatic and is taking abiraterone acetate tablets (1000 mg) with prednisone.

[Tall_Allen]

Good idea to get both a PSMA PET scan and an FDG PET scan before attempting another treatment:

prostatecancer.news/2019/12...

[lewicki in reply to Tall_Allen]

Where can you get the PSMA pet scan? Anyplace other than California?

[Tall_Allen in reply to lewicki]

The OP can get them in India.

[lewicki in reply to lewicki]

To far to go. University of Michigan wanted $5000.00 but turned me down since i still have a prostate. Yes here in the good ol USA

[GP24]

If the PSA value rises after the Lu 177 cycle I would not expect that the next cycle works better. As far as I am aware, most doctors will stop the treatment then. You could discuss a chemo with Cabazitaxel with your MO. Or make a genetic test for BRCA mutation to see if Olaparib will work.

[immunity1]

Your doctor could well be right. With such a delayed session of Lu177 you may be seeing the result of cancer cell damage (PSA up and AP up) fron the Jan 21 dose. So yes I would stick with the next session. Keep an eye on liver function as arbiraterone + Lu177 may cause some minor damage. I dont have info from your PET PSMA scan??