Scans 8 weeks after first Lu 177 treatment

[noahware]

Began Novartis Pluvicto trial on 4/5/22 after failing ADT+abi, Labs two weeks ago showed PSA dropping from about 25 to 2.4, ALP from mid-300s to 187. That was great to see, but the results of my first bone scan (since starting the trial), done earlier today, are not exactly what I was hoping for:

" There is a new focal area of uptake involving the left aspect of L2. There is increased confluence of radiotracer avid lesions in the mid sternum, intertrochanteric left femur, proximal diaphysis of the right femur, and posterior left 10th rib. Several areas of uptake appear slightly less intense on today's study, for example along the left scapula, sacrum, and T6, T8, and T11 vertebral levels multiple additional areas of uptake elsewhere appear similar "

We are comparing to a bone scan done on 2/23/22, so that was six weeks prior to the first Lu dosing and I suppose there was probably some progression of mets over that time before the current treatment regime. Thoughts?

[Still no pain or other bodily indications, to me, that my bones are riddled with osteoblastic lesions.]

Seems like I'm taking out a few of the PSMA-avid soldiers, but plenty of other PC cells are fat and happy.

[Tall_Allen]

Maybe future infusions will get more of them 🤞

[noahware in reply to Tall_Allen]

That's the plan!

[TeleGuy]

Give it time, your first treatment is just a start-- but are you on pause right now because of the Novartis production problem? Wishing you the best, my treatments were very successful but it takes a while.

[noahware in reply to TeleGuy]

Thanks! Heading in today for dose two -- delayed from 6 wks to 8 wks, so only a short pause.

Yes, I realize it takes a few months for most to have a good idea of potential for success or failure. Glad it worked for you, I sure can't complain about my PSA drop (lower than I got on abi, already).

[Ramp7]

I went to Dana Farber yesterday for my 4th infusion. Novartis has corrected whatever their problem was. PSA has continued its downward path now, 0.19. Was also informed of the new name for this medication. "Vipivotide tetraxetan".

[EchoII in reply to Ramp7]

Where did you get the information that Novartis has corrected the problem?

[MateoBeach in reply to Ramp7]

It is still the same radioligand marketed as Pluvicto, just another non proprietary name for it.

[Ramp7]

I was on hold for my next infusion for about 4 to 5 weeks. Last week told to come in to Boston for next infusion. It's been fixed. Dana Farber Doctor told me.

[j-o-h-n]

Good Going....... go when the going is good.....Congrats!!!

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 06/02/2022 6:29 PM DST

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

Thanks!

[MateoBeach]

Sorry to hear of the bone scan progression. But such good PSA response so continue. Understand it has been shown to be sufficiently safe to use Ra223 after Lu-PSMA. So you have that as backup. Hoping for the best for you. Paul

[noahware in reply to MateoBeach]

Thanks, and nice to read your report from Australia... best of luck to you, too!

[noahware]

Yes, I'm not going to worry too much, I figure it's too early to know for sure.