Tomorrow I have bone scans and CT scans in Las Vegas 110 mile drive. Then I meet with a doctor about Xofigo down the street. at Comprehensive Cancer Centers of Nevada
On Monday, I meet with a doctor in SLC Utah Cancer Specialists about LU 177 aka Pluvicto. Not sure if the two doctors will advocate which direction is best for me. What to do? FYI my PSA has risen from .1 a year ago to now 2.5. I have a met in my L-2 and pelvis. Thank you all for your thoughts. Jim
Another consideration is 6 infusions of Pluvicto is a lifetime limit, whereas the 6 injections of Xofigo can be re-done after a wait.
but are they apples and oranges, so to speak?
They do different things, if that's what you mean, They both provide about the same increase in survival. Xofigo provides more pain palliation.
I did not know that. I am going hav to look up the word palliation
Hey Allen
I do not have any pain from mets, do you mean the pain the Xofgo causes vrs LU 177?
pain palliation=pain relief. Xofigo is only indicated if there is bone pain and no visceral metastases.
I have to look up visceral now. I have no pain at all. So should I go with LU 177?
visceral mets=metastases in organs
Unless you have great insurance, you won't have a choice,
so the insurance will not cover LU 177 if it is only in my bones? I guess I will find out Monday
No - who said that? It won't cover Xofigo unless you report pain .
Didn’t yiu say the other day they won’t let you do Pluvicto after Xofigo?
Within 6 months
Thanks again T A for being here!
Good point. Thanks to clarify this question.
OK. Trying to be clear in my opinion only. Since you have only two known bone metastasis sites. And you do not have bone pain. It seems the Xofigo (Ra223) would not be the priority now. The bone scan and CT will make sure there are not more visible elsewhere.
Pluvicto works better earlier rather than at later stages with more tumor burden. So I would definitely keep that appointment and pursue it if it is offered. You will need to have a PSMA PET scan for that (Pylarify).
Since you are exploring all options you may want to consult with a radiation oncologist about targeted SBRT to those two bone sites in case they don’t respond adequately to the Pluvicto, which could still be of benefit in treating other unseen “micro mets “ as long as they still have PSMA on the cells. (Likely if the others show PSMA expression on the PET scan.)
BTW, “visceral” means any other soft body organs other than bone and lymph nodes, such as liver, kidney and “gut”.
Best bet.. check with your doctors. Too obvious?
Are you progressing even though your testosterone is in castration level? (Aka castration resistent disease)How many mets in pelvic bone?
With you only have two bone mets, SBRT may be a good option for you as a MDT (metastasis directed therapy). Even though it is more studied in castration sensitive scenario, there are some data in castration resistant disease and may be a smart way to postpone more systemic approach such as Xofigo or LU
Glad I'm not the only one who has to look up Tall words. I just google them, and then crouch in a corner for awhile.
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