Peritoneal Carcinomatosis

[SF22]

Spent two days in the hospital. CT A/P mod volume Ascites. Had 4700ml of bloody fluid drained from abdomen. New peritoneal carcinomatosis. Last round of chemo Jan./22, PSA 1.1, now 557. Tried Nubequa, no help. Started Keytruda 8/17, second infusion postponed.

If you access my history, you will see that I was DX in 2016 and have had most of the available treatments. I'm looking for anyone whose jorney has taken them down this path. Appears to be a poor prognosis.

[Spyder54]

hi SF22, Im Mike (Spyder 54). Im 68 yrs.(similar). I went to your Bio which is empty, so I read your 3 previous posts. Man, so sorry for your rough journey. You are a seasoned warrior.

You have chosen well, with UofM, and Kwon at Mayo. You didnt give a reason why 2nd Keytruda cxld. Was it because of the 4700 ml of bloody fluid in stomach Im guessing?

On some of the earlier posts PARP inhibitors were discussed. Did you ever learn if you were BRCA 1/2, or ATM? How about Neuro Endocrine positive? There are many guys here with both to assist. Hope you find good solutions soon

You seem like a great couple. Our best to you and yours,

Mike & Barb

[SF22 in reply to Spyder54]

Spyder54

Thanks for the reply. Yes, Keytruda cancelled due to the fluid and scans also found a small blood clot in the lungs. Keytruda infusion rescheduled for next Wednesday. Also a 3 month injection of Lupron. Fluid is building up again, so another paracentesis procedure scheduled for Wednesday. Waiting for the pathology report from the bloody fluid.

I have had 3 Guardant 360, last one showed an alteration of ATM.

Dr. Kwon's office recommended continuing immunotherapy and will schedule a PSMA PET scan. I was scheduked for C11 PET choline scan. I have had three PSMA PET scans since 2018. None have shown a PSMA expression. I did not qualify for LU - 177.

Thanks, and best wishes for you. ( I'll work on that bio!)

Steve

[Tall_Allen]

Did you have a biopsy of any of your metastases? If so, what did it show? Are you a candidate for Pluvicto?

[SF22 in reply to Tall_Allen]

Hi, Tall Allen,

The two metastases I had were radiated in 2018. No biopsy done.

[Spyder54 in reply to Tall_Allen]

Hi TA, isnt Pluvicto the same as LU-177? SF-22 mentions above that he was not PSMA expressive. Mike

[Tall_Allen in reply to Spyder54]

Thanks for letting me know. I don't read others' posts and replies.

[tango65]

Without any recent biopsy you could discuss to do Lu 177 PSMA . Many centers are doing Lu 177 PSMA now and the Lu 177 PSMA may be available by the end of this month.

I think they could do a laparoscopic biopsy of the peritoneal mets and do genetic studies, IHC and histological studies. The results of the biopsy may indicate the cancer could respond to Olaparib, Rucaparib, Keytruda, chemo with platinum compounds or similar drugs.

[SF22 in reply to tango65]

Thanks Tango65

I will definitely mention this about the laparoscopic biopsy.