Lutetium 177 candidates

[Runner1957]

I had a robotic prostatectomy in Oct 20. PSA started to rise in July 21. 1st PSMA PET scan was inconclusive so have just had another and waiting upon results. PSA now 12.3 10 weeks later. Is Lutetium 177 the best option available at the moment?

Live in the UK so private is the only option, I think. I have been given a budget of £12300 per session.

[GP24]

If there are just a few metastases you better destroy them with targeted SBRT radiation. The NHS may pay for that. See this study for SBRT radiation of mets:

jamanetwork.com/journals/ja...

[Runner1957 in reply to GP24]

Thanks, will find out on Wednesday.

[tango65]

If you never had distant metastases you should discuss radiation to the prostatic fossa and whole pelvis radiation associated with ADT.

[Tall_Allen]

You should not use Lu-177-PSMA-617 if you do not have sufficient PSMA avidity - it can increase toxicity.

The possibly curative therapy you should try next is whole pelvic radiation with 2 years of ADT. That will probably be covered by NHS. This therapy was proven by the SPPORT trial:

prostatecancer.news/2018/10...

[GP24 in reply to Tall_Allen]

You have to be in an very advanced state to be able to use an FDG PET/CT to determine if you have tumor which is not PSMA avid. I understand Runner is still hormone-sensitive and I think an FDG PET/CT at a PSA value of 12.3 will not be "successful".

[Tall_Allen in reply to GP24]

I did not mention an FDG PET scan for him. You seem to have imagined that.

[CAMPSOUPS]

Lutetium 177 candidates

I'm going to ask a question that has been with me and the title of Runner1957's post is a good place to interject maybe.

Bone marrow. It seems even if anecdotally that LU-177 is tough on bone marrow and subsequent proper blood counts. Or, the marrow is not healthy enough, or compromised already.

Is there any restriction based on receiving treatment based on blood counts ?--probably of course.

Are there any pharmaceutical/medical interventions prior to treatment to better prepare the bone marrow for LU-177 ?

[Engraver68]

Hi

I am in UK 11 years on from prostatectomy, I had similar PSA so next stage was pelvic radiation then 2 years after bicalutamide tablet for a further 6 years before That failed in 2018.

Then started hormone injection and zytiga, lasted out till last September when I had further radiation to the one metastasis. So far all good. The reason for this timeline is to let you be aware that you have many other options in the bank before you get to consider Lutitium treatment. It's likely by the time you should be considering this it will be standard treatment in UK.

This site will keep you informed of what is available and upcoming, you are very early stage so keep all other options open before you jump into the last chance saloon!

[db1966]

Hi there. Was that quote from the hospital in Windsor?

[Runner1957 in reply to db1966]

I think I found it online but remember Windsor being an option. Good luck.

[Janhpr]

We had a quote from Windsor £13000 + PMSA PET Scan £2500