Actininum-225

[lewicki]

What are the results of this treatment

[HopingForTheBest1]

I participated in a trial at Weill Cornell which included a triple therapy of Actinium + Enzalutamide + Keutruda. Actinium was just one shot, Enza was a daily pill, and Keytruda was an infusion every 3 weeks. Didn't work for me.

[lewicki in reply to HopingForTheBest1]

sorry to hear the negative results. Keep on trucking.

[Hidden in reply to HopingForTheBest1]

Did you have more than one infusion with AC225?

Any problems with the salivary glands?

[HopingForTheBest1 in reply to Hidden]

While the trial lasted 24 weeks, I had just one treatment with Actinium at the very beginning of the trial. That was the protocol. I did have some minor salivary dry mouth issues, which was relieved with regularly using Biotene dry mouth rinse.

[lewicki in reply to Hidden]

I had both AC-225 and LU-177 four times at the University of heidelberg. I am now 24 months PSA <0.04.

[lewicki in reply to Hidden]

I did have salivary gland dry mouth and lost several teeth that had crowns.

[lewicki in reply to Hidden]

I do have salivary gland issues and they are much better now as the body heals.

[lewicki in reply to Hidden]

I am not on any ADT lupron for the last 24 months and have a PSA of <0.04 for the last 24 months. Hope it stays that way.

[EdBacon]

It's a more powerful isotope than LU-177. AC-225 is an alpha emitter wheras LU-177 is a beta emitter. Alpha particles have much more energy and are good at causing double strand DNA breaks (basically game over for a cancer cell)

The problem is the side effects are also worse, mainly the salivary glands which also express PSMA. So my understanding is they are using it along with LU-177 and limiting the dose because of the side effects.

Not sure what if any clinical trials are going on or have taken place. Best to do a search to find out.

[tango65]

AC 225 PSMA may be used when there is diffuse infiltration of the bone marrow since the alpha particles travel less distance than the Beta particles emitted by Lu 177 PSMA. This will protect the bone marrow cells close to the cancer cells and reduce the negative effects in the bone marrow.

The problem is that a course of 3 or 4 treatments will destroy the salivary glands which is significant adverse event.

They may use it in one treatment and then continue treatment with Lu 177 PSMA, or use it in tandem with Lu 177 PSMA, so they can use a lower dose of Ac225 PSMA.

There is a a different ligand of Ac 225 PSMA which uses an antibody to attach the ligand to the PSMA of the cancer cells and it seems not to affect the salivary glands or even the proximal renal tubules. It is identified as Ac 225 J591, and there are clinical trial using this ligand

clinicaltrials.gov/ct2/resu...

This article has some info about efficacy in advance mCRPC:

pubmed.ncbi.nlm.nih.gov/332...

[slpdvmmd]

Had combo of LU177 and AC225 in Heidelberg July 2021. So far so good. One round for oligometastatic Lymph node disease. Dry mouth that is starting to improve the last couple months.

[lewicki in reply to slpdvmmd]

how many times did you go and what were the dosages?

Thanks

[Seasid in reply to lewicki]

good question

[slpdvmmd in reply to lewicki]

I went once. They calculated dose based on tumor volume. 4GBq Lu-177 and 4MBq Ac-225.

[lewicki in reply to slpdvmmd]

Seems to be the same for me.

Although I did go four times.

[lewicki in reply to slpdvmmd]

Good to hear you had good results.