Results of Second Fusion of LU-177

[topofthemountain]

Received the results of my second fusion of Lu-177 in Brisbane Australia. I had my first infusion in Febuary 2021 after Enzalutamide (Xtandi) stopped working and PSA increased to 50. My first infusion reduced my PSA to 3.5. My second infusion on 8 April 2021 reduced my PSA to .6. I will be talking to my medical oncologist in two weeks to come up with a plan going forward.

[Shooter1]

Great results.

[topofthemountain in reply to Shooter1]

Thank you.

[noirhole]

Great results on the PMSA front. Left over cells not expressing the protein are known to re-populate. I would discuss the possibility of chemo or other systemic treatment that would give a double punch to eliminatet those cells to give you a more durable remission. Good luck on your future treatment.

[topofthemountain in reply to noirhole]

I intend to discuss an infusion of RA 223 with my nuclear oncologist. This may get the small tumours that do not exhibit PSMA.

[pilot52]

Not much info here and you are trying to play QB. What was your dose mCi or dpm. Were you chemo naive? It is my understanding RA 223 reduces the effect of Lu-177. With only two doses you can on advice of you nuclear medicine doctor have additional. What makes you think you have PSMA negative cancer. Hoffman is close to you ..Read his material. He is one of the tops world wide in Lu-177. Blue Skies

[j-o-h-n in reply to pilot52]

woof....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 05/20/2021 10:39 PM DST

[topofthemountain in reply to pilot52]

I have never had chemo. My nuclear oncologist follows German protocols with dose and is a good friend with German oncologist Dr Baum. My nuclear oncologist has never had good results with RA 223 compared to LU 177 so in my mind the judge is still out. There is no cure for metastatic cancer, it is all about management and I will be looking at more LU 177 when my PSA doubles in short timeframes. It is my understanding that not all cancer exhibits PSMA. I will be talking to my medical oncologist about an approaches to keep PSA under check.

[pilot52 in reply to topofthemountain]

Good stuff, ok then we have similar profiles and that is where it seems to get gray...I was curious about PSMA negative cells and my nuclear medicine doc listed some criteria of why she felt I did not have these present..1. pain cleared up. 2. my psa fell and continued to do so. 3. It did not bump up . She did state this was clinical observation and not based on trial . I had high tumor load , high PSMA expression, and like you chemo naive. I did however have a higher mCi dose than German protocol. It is my understanding that they are adding a low percentage of AC 225 to a full dose of Lu-177 . Alpha particles have a bigger impact on good tissue but do pack a wallop....Nuclear Medicine is a new paradigm . Tagawa gives one 500 mCi injection in a recent early clinical trial..Being chemo naive allows more lee way in treatment due to bone strength and being earlier in the disease progression. This is not from me but from the direct questions I asked. Just passing it along. I will never recommend a treatment just throw out my limited understanding on this subject. Hoffman , Braun, and Sen, Tagawa seem to be leaders. Sen is about to publish a paper on the use of higher dosages in earlier case presentation. I will look forward to reading it. We now have some major research centers jumping in too. MD Anderson, Duke ect....Blue Skies..

[topofthemountain in reply to pilot52]

I look forward to Sen's paper on use of higher doseages. Thanks

[Hidden]

A tandem ac/luPSMA, low dose ac because of Xerostomia. Enza after 10 days upregulated PSMA by approx 50 %. Have you performed NGS? Brac2 , and you can try Olaparib. Results from CCS1477 should soon be out, Pten Loss relies heavily on upregulated P300 (HAT), maybe you could be eligble for the trial?

[topofthemountain in reply to Hidden]

After discussions with my nuclear oncologist I am not sure about AC 225. Enza failed for me in 2020. I was tested for Brac 2 without success. I have not tried Olaparib but will be expoloring options with medical oncologist in next two weeks. Thanks for your information.

[ARIES29]

I had two shots of LU-177 also in Sydney. Psa went from 19 to 1.6.Great results but now 5 years later psa is back to 19, What to do??

Hopefully latest scan will show where the beast is hiding & radiation will kill it?

[topofthemountain]

Great result. My nuclear oncologist suggested further lu 177 once my cancer psa starts to doubles in a short timeframe. So i will be watching psa level very closely. I have a meeting with medical oncologist in the next two weeks to discuss a plan going forward.Did you have any medicine over the 5 years?

[Ausi]

Hi Tony, I haven’t seen any further posts from you, how did your meeting with your MO go, and have you had a further LUT shot. Why did you opt for this instead of Chemo?I live on the Gold Coast and have been successfully zapping mets over the past few years at Genesis in Tugan. My last treatment was in Dec and my PSA dropped from 20 to 1.6 so I suppose I’m PSMA avid and would respond to LUT. My concern is though I’ve developed radiation cystitis and wonder whether this may be an impediment.

Ian

[topofthemountain]

My medical oncologist is Paul Vasey at Icon Wesley Hospital and my Nuclear Oncologist is David Wong at iMed Wesley Hospital. Paul come from a research background and is not keen on Chemo because of the destruction of good cells. He said "if I was you and could afford LU-177 that would be the treatment I would follow". Both Paul and David are now monitoring my PSA on 3 monthly cycles and I will have further LU-177 when my PSA increases in double time. I like LU-177 as I have no side effects. I also like both Doctor's approach as I know at some point LU-177 may fail me, so prolonging the treatments over extended timeframes may extend my life. In my mind Chemo is a last resort.

Ausi if I was you, I would seek Paul Vasy's advice on your treatment and radiation cystitisas. His approach and advice to date really does impress me. My next blood test for PSA is at the end of July and I am hoping it is still low.