Enzalutamide may have synergistic effect on Lu-177 Pluvicto treatment

[Kayakbob]

found these recent published studies that indicate short-term use (2 weeks) of enzalutamide prior to Pluvicto treatment increases PSMA expression in PC cells, and may have a synergistic effect.

ncbi.nlm.nih.gov/pmc/articl...

ncbi.nlm.nih.gov/pmc/articl...

I'm checking with my RadOnc to see if this makes sense to him before we start Pluvicto (12/23!)...

Does anyone else have any experience with this?

Kayakbob

[GP24]

In Australia this trial is currently testing this combination: pubmed.ncbi.nlm.nih.gov/340... Results will not be available at 12/23. I would take Xtandi before and some time after the Lu177 cycle without asking the RO. If it works you will have a significant benefit, if not it was worth the try.

[cesces]

How can it not have an effect?

[GP24 in reply to cesces]

The effect is based on the observation that Xtandi increases the PSMA expression. So far this is an observation and not based on clinical trials. As Kayakbob wrote: "I'm checking with my RadOnc to see if this makes sense to him". The RO will answer: this is not in the guidelines and there are no trials proving that it helps. Therefore he will not recommend it. This is why I worded my post this way. I took drugs the doctor did not recommend and had success with them.

[cesces in reply to GP24]

What I meant how can anti-androgen therapy not help with radiation treatment.

"The RO will answer: this is not in the guidelines"

Screw the RO. What does the medical oncologist say?

Get some second opinions.

And maybe a new RO.

[Kayakbob]

GP24 - See my original post - there are two published studies showing this effect (BUT, they were small cohorts, 10 in one, 30 in the other) - pubmed.ncbi.nlm.nih.gov/356... and ncbi.nlm.nih.gov/pmc/articl... - (Just noticed that the entire web address was not showing for the study links) If you click on the links, it will bring you to the full study results😇

[PacMan1950]

I'm lucky enough to live in Australia 🦘. I'm having my second Lu-177 treatment (Pluvicto) in 2 days (15th June). For the last 5 days I've been taking Enzalutamide (half dose - 2 pills per day). Bursitis and accompanying pain has returned to my left shoulder. But the pain is not as bad as when I was last on Enzalutamide in early 2022. Seems to prove that Bursitis is a SE of Enzalutamide for me. But I'll keep taking it until Thursday when my treatment is done. In the 5 weeks between first and second Lu-177 treatment my PSA has gone from 470 to 590. NO, this was not my plan but there ya go. More info in my Bio.Paul