LU-177, is it worth the cost?

Hopefully this posting reach those who have gone through the LU-177 procedure. The information/results I'm looking for is the length of effectiveness versus the cost. Myself I can't see spending 40K of my soon to be widow wife's money reserve for 4 months of life. It would take a year anyways. How about everyone else? I'm at the stage where I need to start examining all my options. I'm not going to throw money away for a few extra months of lousy life. Opinions, experience's please.

[Tall_Allen]

There is no data yet to help you make that decision. It's expected soon.

[AlanMeyer]

From what I've seen, the results of the treatment can vary anywhere from spectacular success that clears up almost all of the metastases and leaves the patient in great shape for a couple of years, down to no help at all, just unwelcome side effects. Getting a PSMA scan beforehand can identify men who are most unlikely to benefit because they have metastases with very little PSMA, but even among men who are loaded with PSMA, the response is not always what we hope for. If you look up the clinical trial reports you'll get some idea of the percentage and characteristics of men getting each level of success.

So it's a crap shoot. If you can get a PSMA scan at a cost that isn't too much then, if it showed that you have lots of PSMA, I'd seriously consider the treatment. If it shows you have very little, then maybe skip it, not only to save money but also to avoid wasting your remaining time.

I don't know if you're still working or if you like your work, but it's conceivable that if you got a couple more years you could earn back the money to pay for your treatment and even enjoy doing it. Then of course battles with insurance companies and/or appeals to charities might also tip the odds. Also of course there is the question of how well your wife can live without the $40 K. I'd be willing to give up a lot of money to keep my wife alive for a couple of years. She might have the same feeling about you.

I feel for both of you in this situation. Life can be very tough and present us with hard and uncertain choices.

Best of luck.

Alan

[Hidden in reply to AlanMeyer]

Thank you Alan, nice to see you again.

[Carol2]

Even tho my husband has now passed away, he had an extra two years from this treatment, costing $60,000 in New Zealand. I wouldn't trade that time and consider that it was worth every penny. He had this extra time seeing his grandchildren grow into very lovable teenagers. I know it is extremely hard going and I wish you well.

[immunity1 in reply to Carol2]

I believe my story is similar to yours after 7 sessions of Lu177. I am very sorry to hear of your hasband's death.

[j-o-h-n in reply to Carol2]

Dear Carol, You have my sincerest condolences with the passing of your dear husband Ray.

j-o-h-n Wednesday 03/17/2021 9:54 PM DST

[Steve_Skiba]

Hello fellow warrior. I was able to do the LI177 when it was on it’s final trial so it was free to me. It brought my final psa from 150 ish to 0.07 in 6 treatments. However as soon as the trial was over my PSA started climbing back up immediately. Initially we were very excited but that was dashed away pretty quickly. My side effects were pretty minimal in the first four treatments. In the last two I started having some head stuff going on. A lot of anger and sadness. I never heard if that was the norm as far as any of the issues I experienced. During the treatment My bone and tumor Mets decreased some, but not significantly.

I began Cabazataxol three weeks ago. Getting ready to have my second treatment tomorrow. (Right now our roads are closed because of a huge snow storm that came through). It looks like we’ll be rescheduling. I have an ostomy as of December 21st 2020 because a tumor in my pelvis has squeezed off my colon. I am probably down to my last bit of life. We don’t know yet if this round of chemo drugs is going to work. Waiting also to get an MRI to see what all is going on within my body. I can tell you from the consistent pain I’m experiencing it’s probably not good. So... all that to say “was it worth it”. I got 4-5 more months of additional life and felt pretty good overall during treatment. My wife would say it was definitely worth it. I would have struggled mightily with having this treatment if I had had to pay for it. I believe others have had great success with it and it has kept the numbers down longer than it did in my situation. It’s all just such a crap shoot. Resources are tight and nothing’s guaranteed. I wish I could give better, precise information.

Good luck to you friend.

Steve

[Boywonder56 in reply to Steve_Skiba]

Peace brother may i find your strength....

[GP24]

My observation is that Lu177 works better early in the disease course than e.g. after Cabazitaxel does not work any more.

There is some data from this trial: link.springer.com/article/1...

In this trial they observed an OS between 8.9 and 14.6 months after the Lu177 therapy:

"Patients without any prior chemotherapy showed a significantly longer OS (14.6 months). The median OS in patients who received one or two lines of chemotherapy with docetaxel or docetaxel followed by cabazitaxel, respectively, was 10.9 months and 8.9 months."

[immunity1]

Check out my profile since Dx in 2010, with 7 Lu177 infusions. Obvious I dont have a control!

[Barree]

"Nuclear Medicine and Lutetium 177 PSMA Therapies - Carmel Pezaro"

If you type the above into your browser (the video is on URO today) will find this video of two Doctors discussing: - two of the scans used in the Lutetium -177 Thera P Trial. These scans are just two of the tests used to determine if patients are likely to respond to treatment with Lutetium, before enrollment on this trial.

Not everyone is suitable for treatment with Lu-177. It is pointless to undergo treatment unless the preliminary tests and scans show you are PSMA avid and your bloods tests are in line with the requirements specified as prerequisites for this treatment.

If you live a long way from a treatment center in some instances it is possible to have these scans done at a local hospital prior to attending a treatment centre.

If after viewing this video you are in any doubt as to your suitability for treatment with Lutetium -177 whatever you do seek further information. I have seen some patients undergo treatment that will not work.

I was a patient on the inital trial in Australia. Most patients on this trial had 4 infusions.I've since had additional infusions.

I feel the above info given by GP24 as to OS is as good as is available.

at the moment.

Good Luck. I wish you well.

Barree

[CJ4J]

Well I would say more time is worth it, but there was no expense on our behalf. My husband was apart of the vision trial. First infusion was Jan 2019 and reached undetectable by May 2019 after 3 treatments. Finished in August 2019 and was in good shape but didn't have a reoccurrence until Feb 2020. So, that gave he and I time to travel to Maui, Estes Park and the ability to hike.

Now fast forward to today, March 2021. He now as of this weeks trip to Mayo clinic has a major problem. Petscan was clear in January 2021 but now has 20-25 new mets in a little over a month and a low PSA of 2.8. So, the cancer reoccurrence has come on very aggressively. Jevtana plus a platinum is recommended and the outlook is grim.

I am thankful for that extra 2 years of pretty good health with no complaints or side effects. We would have traveled more if it weren't for covid.

What is time worth to you?

[Peterd110 in reply to CJ4J]

Can he repeat the lu177?

[CJ4J in reply to Peterd110]

Good Question Peterd110, we asked that as well. We were told, no one really knows what this would do to his body after 6 treatments and if a Dr would be willing to do this. So, for now, chemo is the next thing.

[ARIES29]

Hello Nonamelame, It worked for me but obviously does not work for everyone. I had two infusions & got my psa from 18 to 1.6 in 2018 but now psa is 12.1 & rising & wish I could have it again. The only treatment I had before that was one shot of Lupron & cassodex 3 months.In summary it gave me 2 to 3 years of life before it came back so it was worth every cent to my family.