My dad got his first dose of Ac225 on last 25th,and the latest PSA today raises to 220 while when he got treatment, it was around 50, 4 weeks before.
Some docs think that it could be a one time off,and has been observed after many treatments like Ra223.
Wondering those who have experienced Ac225 or Lu177 before, how long does it take for your PSA starting to go down?
Thanks!
In this study they did PSMA PET/CT to evaluate response 6 weeks after the 1st treatment.
The PSA response was evaluated 3 to 4 weeks after the treatment.
" Biochemical response to treatment was assessed according to the Prostate Cancer Working Group 3 criteria (PCWG3). According to the criteria, partial response was a >50% decline in PSA from the baseline with confirmation after 3 - 4 weeks, and a >25% increase in PSA level above the baseline was deemed biochemical disease progression"
However, most patients had a decline in PSA at 8 weeks after treatment.
"After the initial cycle of 225Ac-PSMA-617 TAT at a median of 8 weeks, 25/28 (89%) patients experienced any PSA decline; interestingly, 7 (25%) patients experienced remarkable >50% PSA decline even after the first cycle of TAT."
It can go up temporarily due to dying cancer cells, but it should go down by now. Has he had an FDG PET scan?
Hi Tall-Allen, that's what I concern ... we had a FDG PET before Ac225, and showed negative on Neuroendocrine, but doctor said, based on biospy from my dad's liver mets, he might be not benefit from Ac225. I haven't gotten the full report so I don't know the reason behind.
Neuroendocrine? Why did you suspect that? FDG doesn't specifically show that. Did his liver show up on FDG but not PSMA.
I think I red a report, PCa with liver mets, ~60% was driven by NEPC. Luckily he wasn't, his liver mets with SUVMAX 28.
NEPC is rare, but there are other types of PCa that do not express PSMA. With an SUVmax of 28, and negative FDG, there should be some benefit. Maybe a PSMA PET scan will show some reduction.
Yes, thanks, definitely will do before next dose, thanks a lot Tall_Allen, I red lots of you post, an expert indeed.
Also, see this about salivary injury. Also, he should be avoiding MSG.
prostatecancer.news/2021/01...
Sure, thanks. So far he feel nothing, and hemogram hasn't been influenced, so I thought to increase the dose a little bit next time.
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