Just got a call from my Doc giving good news that there are no genetic mutations affecting my case. He suggested to take Xofigo + Xtandi or ... Chemotherapy. Tough choice but the Zytiga is not working.
Meanwhile he accepted my suggestion to try the SLASH /Lu177 clinical trial as long as it doesn't have a late start. Of course I need to get accepted...
...if not, any pros /cons if going Xofigo vs Chemo ??
Lots of combos with Xofigo are possible - several clinical trials:
prostatecancer.news/2021/02...
.... if not accepted the Lu177 trial, I am debating between Xofigo or Chemo... sort of inclined for Chemo ... as I can be able to get Pluvicto after.
If you start any of those treatment , you will not qualify for the Lu 177 PSMA trial. If your only systemic treatments had been ADT and zytiga the odds are in your favor you will qualify for the trial.
I would try to get into the Lu 177 PSMA treatment which may have much less negative side effects than Xofigo or chemo.
That is my plan assuming I am accepted the Lu177 trial.... if not, I am debating between Xofigo or Chemo... sort of inclined for Chemo ...
Xofigo is not a systemic treatment like chemo, it only treats bone metastases. There is some info about combining chemo and xofigo treatments, which seems to make chemo more effective
ncbi.nlm.nih.gov/pmc/articl...
Regardless of treatment with chemo, xofigo or Lu 177 PSMA, you should request Provenge , a vaccine shown to prolong life. It can be done with Xofigo and I believe with chemo.
If doing xofigo, one needs treatment with denosumab or zoledronic acid.
I would wait a few years before staging any psma treatment.
They have a new version that won't damage your kidneys and salivary glands.
If androgen deprivation is still working, why drop it?
What is the new version of Pluvicto called that doesn’t damage salivary glands or kidneys? I am scheduled for Pluvicto treatment next month.
Mike
I forget. Tall_Allen mentioned it here.
I have to say I was an early fan of psma treatment, but as I learned more about it, it seemed like the side effects plus it's limitations (it misses non-psma prostate cancer cells) makes it a dubious treatment until you have exhausted all other lines of treatment.
There is a reason they limit you to 8 treatments total.
And the long term effects of losing or a material reduction of renal or salivary function are just as bad as the disease you are attempting to treat.
And you can't rely on the docs to do a good job of fully apprising you of side effects.
They just never do a good job at that. And often it seems they don't even make an attempt.
If you don't look after your self, and ask lots of questions, and get a few second opinions... no one else will look out for you.
He suggested to take Xofigo + Xtandi or ... Chemotherapy. Tough choice but the Zytiga is not working.
I'm not sure what I think of your situation. Now that Zytiga has failed chemo alone is often given to reset the cancer playing field so that Xtandi may work.
You don't mention any lymph node involvement so that could be why Xofigo which is better for bone metastasis is mentioned. Possibly Xofigo changes the cancer playing field so that Xtandi with it is beneficial. It looks to be a good combo. Please read the link Tall Allen sent you here.
I myself with diffuse bone mets and lymph node involvement am in preliminary stage of applying for a trial (Dora trial) possibly combining Xofigo and Docetaxel now that after about 3 years the effect of my first chemo therapy at diagnosis and later addition of Zytiga are not holding things down.
If you have interest in Lu-177 (Pluvitco) keep in mind that I think you have to wait 6 months after any chemo before you can have it.
I just finished xofigo. I had almost no side effects; just a little nausea. I was told 12 weeks before I can continue other treatments.
(All my many Mets are in my bones. The treatment worked well to shrink them a bit.)
Cool. Thanks.
I know we are each different but SE's from Xofigo seem to be not too bad for most. Some fatigue and diarrhea for a day or so a few days after infusion.
Thanks too for the heads up on 12 weeks until next treatment after Xofigo. If I get on the trial and if I do get the Xofigo will be good to know as I wanted to inquire about quickly getting Provenge after the trial infusions, if any benefit.
Yes me too. Skull to shins bone mets and 3 years in looks like they are still active but not about to kill me within months as they were at the time of my diagnoses.
What type of scans did you have to monitor baseline and results?
Started at 900, ended at 73.
Your Xofigo Experience 
Radium 223 Xofigo Treatment
Xofigo & Ac- 225 After failed Lu-177
Gratitude & Radiation & Xofigo
Xofigo anyone?
