test Enzalutamide or Lu 177 for the first line therapy?

[Samani]

I am thankful if anyone can help me.

My father PSA is 157 after 8 sessions of Docetaxel with 150 mg dose and 2 months Abiraterone after chemo. His health is not in a good way, anemia, loss of appetite, nausea and neuropathy.

In the last blood test:

Ferritin >2000 ng/ml

CEA 12.79 ng/ml

CA 19-9 50.51 U/ml

Are these markers sign of poor prognosis?

I wonder what is the best treatment to test lowering PSA now, Enzalutamide or Lu 177?

I appreciate any idea.

[GP24]

I would take both combined. Pluvicto has fewer side effects than Docetaxel. This should help him and Enzalutamide will support this treatment.

[Samani in reply to GP24]

Thank you.

[Tall_Allen]

Pluvicto after abiraterone fails

[Samani in reply to Tall_Allen]

So may Pluvicto works after Enzalutamide?

or base on dear GP24, take both simultaneously.

what about Cabazitaxel?

[Tall_Allen in reply to Samani]

It is indicated for use after abiraterone fails. He will be required to get a PSMA scan to see if it is PSMA-avid first.

prostatecancer.news/2019/12...

[Samani in reply to Tall_Allen]

Thank you.

[Cateydid in reply to Tall_Allen]

good morning, kind sir. The link you supplied gave me such great info! I’ve taken notes to ask the onc about today. Wondering if there’s anything more recent than 2019, or is there some way to know that this info IS the most up to date?

[Tall_Allen in reply to Cateydid]

it’s up to date

[Samani in reply to Tall_Allen]

Excuse me, how do we know that it is PSMA-avid or not? I mean, in his PSMA scan, the SUVmax is around 10, while before chemo was around 60.

[Tall_Allen in reply to Samani]

10 is sufficiently avid

[Samani in reply to Tall_Allen]

Thanks. God bless you.

[tango65]

Having neuropathy more chemo may be unwise, so Lu 177 PSMA treatment may be the way to go.

[Samani in reply to tango65]

Thanks.

[Bangkok]

read my posts. If you can afford it the Lute -177 is a good way to reduce the mets but I had to follow up with 20 rounds of IMRT then I went on Hormone therapy to maintain a low PSA. I have been 0.01 for 18 months but I have gained 10 lbs and attract mosquitos -but I'm still standing.

[Samani in reply to Bangkok]

Thank you so much. So helpful. Hope you’re doing well.

[monte1111 in reply to Bangkok]

I am late to the party, but you are funny. Bet those mosquitos did their business, flew off, and dropped dead.

[Kayakbob in reply to monte1111]

..did the mosquitos flying away look like fireflies???😜

[monte1111 in reply to Kayakbob]

Showed my young granddaughter my new bug zapper that I was so proud of. A moth hit it, caught on fire, and went down like the Red Baron's last day. I don't know which of us was more horrified. Try and explain yourself out of that one.