Update-1st infusion Lu -617 - Advanced Prostate...

Advanced Prostate Cancer

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Update-1st infusion Lu -617

MarkEmrys profile image
36 Replies

Hi all

I promised some people a bit of a short outline of experience of 177Lu-167 therapy.

Had 8.1 Gbq yesterday. Administered after saline solution, then half hour of Lu-617 followed by more saline. Throughout was sipping on lemon water to protect salivary glands.

Only side effect so far is mild fatigue.Baseline fbc, eflt psa etc done two days prior. Next infusion in 6 weeks; was to be 8, but on discussing with Dr Wong there is no real therapeutic reason for 8 vs 6 weeks. so ive gone for 6 week interval.

Will know whether there is any significant effect after scans etc following second infusion.

Cheers

Mark

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MarkEmrys
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36 Replies
Spyder54 profile image
Spyder54

Thanks Mark. Yes please. Keeping us updated. Mateo Beach is on a similar path. We will learn from our Brothers. EARLY seems more effective, is a recurring theme, on so many of these treatments. Hit it when its weakest. “EXTINCTION VORTEX” is what Paul calls it. Best of luck to you and yours,

Mike

EdBar profile image
EdBar

Curious about the lemon water hadn’t heard that before?

MarkEmrys profile image
MarkEmrys in reply to EdBar

I expected ice to cool salivary glands — i guess to reduce blood flow. They do the lemon water sipping to get a protective layer of saliva. Not aware of any proper studies on this.Cheers

Mark

BFOFARMO profile image
BFOFARMO

Mark, Thank you for your post. I’m looking forward to hearing more as your treatment progresses. Best wishes for you and yours on a healthy outcome.

Richard

MarkEmrys profile image
MarkEmrys in reply to BFOFARMO

Thanks Richard

TJGuy profile image
TJGuy

Hi I have lots of question on this for anyone to answer?

Lemon water? To get your saliva glands squirting I guess?

We heard in the past about trying to cool saliva glands with ice applied to the skin to prevent damage to them?

Where is the science on this today, around the world? India, Germany, US, etc?

Is LU-177 approved for general use for PC patients in Australia.

In the US it was recently approved for certain PC statuses. What it will actually cost to get that Drug into your body for each treatment with approval of up to six injections? Anyone know?

Drug company will charge hospital or clinic $42,500 for each injection for just the drug. Does facility double drug cost and then add all the charges for medical personel, supplies, room charges, etc etc? Could this cost $90,000 or more for each injection?

Has any US insurance said they will pay for it?

Anyone actually received this in the US outside of trials?

NWLiving profile image
NWLiving in reply to TJGuy

Just now!

MarkEmrys profile image
MarkEmrys

HiLemon water sipping was to get the saliva moving. It’s a practice used at i-

Med Wesley Hospital Brisbane Australia. Not aware of any peer reviewed papers on this.

Cheers

Mark

docbulldog profile image
docbulldog

I am looking for similar information. My U of Washington OC has suggested my local Cancer Center reach out and find a facility where a PSMA scan and LU-177 are available after the FDA approval. No luck so far, very little information coming my way. It may be a new round of a different Chemo in the meantime. Good luck on tracking down the needed information.

Leader4077 profile image
Leader4077 in reply to docbulldog

I think the U of W and the Seattle Cancer Care Alliance we’re going to offer Pluvicto this month until the suspension of production announcement on May 5………who knows how that will affect insurance coverage……..looking to consider another 1-3 rounds of chemo while waiting……… must be off chemo for at least 4 weeks before first Lu-177 treatments.

Mike

docbulldog profile image
docbulldog in reply to Leader4077

Thank you for your reply, I will be back in the states on Wednesday and will probably get that bad news. Best of luck, I assume I will be back on the second round of a different Chemo.

j-o-h-n profile image
j-o-h-n

Cheers MarkEmrys...

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 05/01/2022 10:35 PM DST

MarkEmrys profile image
MarkEmrys in reply to j-o-h-n

Appreciate your message of support John.

Bvilkid profile image
Bvilkid

Mark - we’re all rooting for you and following your updates. I’m interested in how you ended up here. Could you give a little history- how long have you been in the fray?

MarkEmrys profile image
MarkEmrys in reply to Bvilkid

Dx m1 oct 2019. Mets to iliac and scapula. Docatexel and fiirmagon upfront followed by ebrt to pelvis and prostate. Abiraterone plus prednisone worked for a year. Then SBRT. Following progression now doing lutetium…

Bvilkid profile image
Bvilkid in reply to MarkEmrys

Thanks!

d3is4me profile image
d3is4me

Hi Mark thank your for your LU treatment update interested in your LU journey . I am in Brisbane tried for first line LU treatment but refused by 3 different doctors did not try I-Med Wesley ALL the best with your treatment

MarkEmrys profile image
MarkEmrys in reply to d3is4me

Thanks- a/prof wong at i- med Wesley v. Experienced with Lutetium…

d3is4me profile image
d3is4me in reply to MarkEmrys

Mark thanks for your reply I am interested to know if you have had exposure to chemicals/fumes/ bad dust during your life. As when i was diagnosed 12/2022 told PC was advanced & aggressive and matched with 3% of advanced PC most of whom had Agent Orange or were Farmers or Firemen. I have had exposure to chemicals/fumes /dust

MarkEmrys profile image
MarkEmrys in reply to d3is4me

Yes. 40 years ago I worked in mining exploration for uranium in central western Queensland for 5 months,

j-o-h-n profile image
j-o-h-n

"discussing with Dr Wong there is no real therapeutic reason for 8 vs 6 weeks. so ive gone for 6 week interval."

Sorry Mark, I forgot to mention that I think Dr. Wong is right.

(Keep up the good work).....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 05/02/2022 4:04 PM DST

MarkEmrys profile image
MarkEmrys in reply to j-o-h-n

Thanks John

KocoPr profile image
KocoPr

Thank you Mark for keeping us all informed on this new treatment. I am HSPC With mets to lymphs in pelvic and chest and am going for my OC consult at MSK in NYC this week for a phase 1 trial of lu177 and SBRT .I will also post my experience with specifics.

On a new thread as my case is not advanced CRPC, but it is prior to any ADT treatments.

Best of luck to you and im pulling for you.

John

MarkEmrys profile image
MarkEmrys in reply to KocoPr

Thanks johnGood luck with your approach.

KocoPr profile image
KocoPr in reply to KocoPr

I didn’t qualify for the Lu177 because i had 5 separate tumor locations, 3 was the max in the inclusion criteria. They should have told me before i drove 4 hours to the big city.

Seasid profile image
Seasid in reply to KocoPr

We all should read the inclusion and the exclusion criteria. Could you maybe ask them for exception?

KocoPr profile image
KocoPr in reply to Seasid

I did and it was no. I did read the inclusion exclusion criteria but the administrators said come on down, then when I met with an oncologist he was not the OC on the trial and he thought I was there for a second opinion. When i told him why i was there he looked up the trial criteria and said I don’t qualify but he would check with the trial OC. This same thing happened when I wanted to participate in a trial at Dana Faber. I am learning the pitfalls of hospital staff not talking to the other hand.

Seasid profile image
Seasid in reply to KocoPr

"but he would check with the trial OC" so can you do the follow up call about this? Or at least a follow up email? I believe that it is in there interest to have someone with 5 bone mets instead of only 3. The Lutetium should mopp up the rest. Or you could come to Perth like Mateobeach... He had only 2 Lutetium infusions. I think 2 weeks apart. That would be even better for you?

KocoPr profile image
KocoPr in reply to Seasid

I just went through the exclusion criteria and it is a no go since i am on ADT that lowered my PSA below the criteria and T is to low also now.

Seasid profile image
Seasid in reply to KocoPr

Can you give us the link for that clinical trial at MSKcc?

KocoPr profile image
KocoPr in reply to Seasid

NCT05079698

TA pointed me to this trial. It’s phase 1 but it is only recruiting 6 people at MSKCC NY. I normally don’t look for phase 1, but it is phase one because they are combining two approved treatments SBRT and Lu177

Seasid profile image
Seasid in reply to KocoPr

Thanks

slpdvmmd profile image
slpdvmmd

Thanks for taking time to update us. Wish you well.

docbulldog profile image
docbulldog

Thank you for updates on your treatments, I hope you the best. I have been told a PMSA scan is necessary before starting the LU-177 treatment, but isn't there several PSMA scans? If so, which is recommended?

MarkEmrys profile image
MarkEmrys in reply to docbulldog

Hi docbulldogIn Australia the main use is gallium-68 PSMA PET-CT (Gallium PSMA-PET scan and CT scan). Im aware that there are various kinds of PSMA-PET scan available but am not qualified to advise on which may be "best". For Lutetium therapy, they also do an FDG scan to find out if there is concordance between PSMA and non-PSMA avid lesion areas. Issues occur if there are non-PSMA expressing tumour areas.

Cheers, MarkEmrys

KocoPr profile image
KocoPr

Hi Mark, how are you feeling after your Lu 177 treatments? Any updates?

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