225ACPSMA617 vs LU177PSMA vs DOCETAXAL(or any other chemo) all of these after failing abiraterone

[Nirman]

Abiraterone failed psa 3.30. New mets appeared on Psma let scan no prior treatment before that other then triptorelin injection and abiraterone with prednisone last 3 and half years, now someone please help deciding between docetaxal vs 225AC PSMA617 vs Lu117 Psma and moreover that if anyone have idea about 225ACPSMA 617 treatment given at Fortis hospital Gurgaon India by Dr Ishita Sen I mean experience of treatment side effects and results

[Tall_Allen]

These may help:

prostatecancer.news/2020/05...

prostatecancer.news/2021/01...

[GP24]

You should get a test for BRCA mutations to see if Olaparib may help you.

I would not take Ac225 now, because it destroys your salivary glands. This can be avoided with a combined Ac225/Lu177 infusion. If this is offered in India, I would get that. Otherwise just Lu177.

[Nirman in reply to GP24]

No olaparib as brcas and msi came negative

[tango65]

The main indication for the Ac 225 PSMA treatment is diffuse bone marrow infiltration by the cancer. If they use Lu 177 PSMA in these circumstances , more bone marrow could be damaged.

Ac 225 PSMA emits alpha particles which travel a smaller distance than the beta particles emitted by Lu 177 PSMA. With Ac 225 less normal cells adjacent to the cancer will be affected by the radiation.

If the cancer is not causing bone marrow infiltration you could consider Lu 177 PSMA treatment instead. Besides Lu 177 PSMA does not destroy the salivary glands.

[Nirman in reply to tango65]

Yes talked to doctor she advised lu177

[tango65 in reply to Nirman]

Best of luck!!

[Nirman in reply to tango65]

Thank you

[MateoBeach]

Would start with Lu177 and follow response. Only add in the combo with Ac225 if needed later at an experienced center.

[Nirman in reply to MateoBeach]

Yes Doctor said exactly the same thank you

[Patrick-Turner]

I had Zytiga give me 8 months of slowing down Pca progression where Psa did not increase, but was 12.5 after 8 months. Then I had chemo which pushed Psa to 50 after 5 doses, and I'd already arranged to get Lu177 from Theranostics Australia because it was available here in Australia in Sydney, and I only had to travel 300km to get it from where I live in Canberra. See what happened to me at my website page at

turneraudio.com.au/Patrick-...

After Lu177 did all it could do, I am now going to start with Zofigo, ie, Ra223, because I now only have bone mets, and Psa is probably now about 100.

But I have no lasting side effects from Lu177, and still I have no symptoms of Pca, and am able to cycle 200km+ a week at good speed. I am 73yo.

Docs say I am doing OK with such aggressive Pca.

I have never tried Ac225 which works on same principles as Lu177, but is more powerful alpha particle emitter so side effects will be a permanent dry mouth and maybe dry eyes. Lu188 is beta particle emitter and side effects are less, even after my 6 doses.

Patrick Turner.

[mg_22]

Hi Nirman. Hpe things are well 4 years later. i have a similar situation withmy father (85yrs old). Moved from Enzulatatmide to arbiterone- arbiterone could not control SA so decsiosn point was chemo or Lutetium 177. We are deciding to go with lutetium as seems to have lower side effects. any thoughts based on your experince- what treatement did you end up doing.