Anybody have a PSA and ALK flare after their first round of Lu 177? Thad’s has gone from 25 to 35 PSA and ALK from 160 to 212 three weeks after first treatment.
PS - I’m thinking it’s bad news. Don’t think you have to cheer me up. I’d just rather know about your real experiences.
PSA and bone flare are associated with different PC therapies. It seems infrequent with Lu 177 PSMA treatment. It may be more frequent with Xofigo (Ra223).
I know it's difficult, but I wouldn't look too closely at the blood tests after only having one treatment. The changes really aren't that big anyway. I don't think you can draw any conclusions yet.
For many, this would be a small increase. I’m always surprised by men who have levels in the hundreds. But for Thad, it’s the biggest PSA leap that he has had over the past 8 years. Also the very highest ALK, and the biggest leap on that one. Thad’s psa has always moved in small increments and never has been this high despite bone Mets from the start 8 years ago. He has bone Mets throughout now. We have pretty much gone thru every treatment. Surprised by it and haven’t found any studies that talk about a PSA flare with this treatment. Sigh. Not looking good but this treatment is new here.
There is some info about PSA changes 6 weeks after Lu 177 PSMA treatment and outcome.
That study is a bit of a worry - maybe the test at 3 weeks is different than 6 weeks or there is some other confounding factors. Always something. Good to have some real data.
To date I have received 5 infusions with one more scheduled. PSA is but one marker. From what I am told, the scans tell the actual picture.
I e bad two Lutetium617 infusions. At Wesley Hospital in Australia they decide whether further infusions are worthwhile with PSMA-PET/CT scan 6 weeks after 2nd infusion. Obviously better to have PSA reduced. From what I’ve read a PSA increase above 25% is associated with a poorer response.
My husband was warned he might have a flare after 1st Lu went from 10.4 to 10.8. Had 3rd Lu and after 4 weeks PSA 4.2. We were told you will know after 2nd Lu and Ga PMSA PET Scan.
What mCi dose did he receive and how many rounds are planned? I actually traveled to Delhi and have taken Lu-177. With some info I could ask my provider as we stay in touch. That is up to you.....Best thoughts going forward.
Hopefully, just a 1st treatment flair as others have experienced. My response appears to be fairly unusual. I had a similar response after my first treatment with a lot of pain in first week following treatment and PSA and ALK going up a bit after 3 weeks. Before 2nd treatment, PSA went down a bit. After 2nd treatment PSA and ALK rose at 3 week and 6 week intervals. Debated on 3rd treatment which I did, but saw a continued rise in PSA afterwords. Unfortunately, my blood levels tanked (hemoglobin and platelets) requiring blood transfusions and not many options. All the treatments over the years, the Lu177 and the recent growing cancer have made it harder on my bone marrow.
Hey, thank you for letting me know. Thad had a lot of pain after 1st infusion. It’s such an impossible choice- continue with the hope it will get better and feel worse with the treatments or stop and go down the road of increasing disease and then the end. We did have a very nice dinner last night with lobster rolls and friends over. And it’s an amazing sunny day here today.
Continue to live life in the moment as much as you can! I hope Thad will respond well. More people than not get some kind of response reducing or stabilizing the PSA. I would keep an eye on the blood levels. For some reason, the cumulative effect of the 3rd treatment really had an impact on mine. Also, I wanted to do scans after the 2nd treatment, but my MO said too early and we waited until after the 3rd treatment. I was PSMA avid and concordant with lower volume disease before starting Lu177. I had an FDG and PSMA PET/CT after the 3rd treatment and once again I am PSMA avid and concordant with unfortunately lots more disease throughout my skeleton. We were both surprised. Still hopeful for something else!
As HDguy61 said: "Hopefully, just a 1st treatment flair as others have experienced." If not, an FDG-PET/CT can be used to detect cancer which is PSMA negative and cannot be treated with Lu177.
Of course, I know nothing. Wishing you both the best. Was hoping Tall_Allen would weigh in. It looks like it's a time will tell thing. I know you are worried. But stop it. It doesn't do any good. Now you've made me worried. I've got a left over Big Mac. Guess that will have to do.
Happy you had lobster rolls and friends. And a sunny day. Monte
GP24 profile imageGP24
6 hours ago
As HDguy61 said: "Hopefully, just a 1st treatment flair as others have experienced." If not, an FDG-PET/CT can be used to detect cancer which is PSMA negative and cannot be treated with Lu177.
I like that as well. An FDG-PET. The possible downside but I have no idea is if insurance would cover especially since insurance covers the first scan pre treatment of FDG-PET/CT with the PSMA scan.
My understanding is the LU is killing off a lot of PCa cells. Dying cells give off a lot of PSA. It may be GOOD NEWS! Mike
Lu-177 trial
PSA and Alk. Phosphatase
LU-177
