I can’t remember if I posted this. I am scheduled for lutetium on November 15. I have had (carbotaxel + docetaxel). Gone through Zytega, Xtandi and two years of Lymparza. I have had an FDG scan plus pet scan. They indicated that I have Mets in bones and lymph glands no surprise l Have a high mutational tumor burden sometumors have good PSMA Expression and then many do not . I think the lutetium is like a Hail Mary to be followed up with Keytruda if it does not work. Any and all discussion about my situation will be appreciated.
Lutitium and last resort : I can’t... - Advanced Prostate...
Lutitium and last resort
Please go over this with your doctor. The concern is that Pluvicto may actually allow the non-PSMA-avid cancer cells to take over and grow faster:
prostatecancer.news/2019/12...
You may be better off with one of the BiTE clinical trials described in that article.
The way to predict response to Lu 177 PSMA treatment has been studied.
If the SUV mean of the PSMA positive lesions is less than 10 and/or the discordant negative PSMA lesions found in the FDG PET/CT have a volume of 200 ml or more, the response to Lu 177 PSMA treatment is poor.
thelancet.com/journals/lano...
The other problem is the diffuse infiltration of the bone marrow by the cancer which could lead to bone marrow depression during Lu 177 PSMA treatment even when there is a low global response. Try to find out if the PSMA PET/CT showed bone marrow infiltration.
You could consider getting a second opinion about doing the Lu 177 PSMA treatment.
Is AC-225 available to you?