177Lu radioligand from SPLASH trial not working (yet)

[joeguy]

Had my first infusion of 177Lu as part of the SPLASH trial Nov 9. Had a substantial increase in low back pain, so an MRI of lumbar area was ordered yesterday. The MRI showed there had been progression to bone and lymph node mets in the area just since Nov 9. Was expecting mets would be shrinking from the 177Lu treatment, but no such luck. They tell me that it often takes the 2nd or even 3rd dose before it starts working. Will be getting some palliative beam radiation to lumbar mets to help with the pain, and keeping fingers crossed the 2nd dose of 177Lu in 4 weeks starts doing something.

[keepinon]

Finger's Crossed!

[joeguy in reply to keepinon]

thanks

[ragnar2020]

joeguy,

Best of luck and I hope you are one of the guys who responds well.

Jeff

[joeguy in reply to ragnar2020]

thanks ragnar

[Fightinghard]

joeguy

I completed 3 rounds of LU as part of splash. Some soft tissue mets resolved but bone mets kept growing fast. After round 2 had general bone pain and worse pain after round three. MO pulled me off trial and has me lined up for SOC chemo in couple weeks.

I hope the LU helps you.

[joeguy in reply to Fightinghard]

Sure hate to hear that. I have heard that something like 60% have a good response. I wonder if a person is one of the good responders if you would see a benefit after the first round? Apparently I have progression after round one in both bone and soft Mets. Did they give you any indication as to why you failed Lu ? Where did you do the SPLASH trial? I’m at UT Southwestern in Dallas

[Fightinghard in reply to joeguy]

mine was at Moffit in Tampa

MO said they are now finding that maybe 25% or so of the LU patients are reporting increased bone pain. Mine was severe, ribs back hips all hurt. dr gave me steroid pack for few days to reduce the general inflammation, that helped, but as steroid faded the pain ramped up. Still not as bad as it was before steroid.

Everyone reacts differently. Hoping your results are better.

[joeguy in reply to Fightinghard]

I noticed a big uptick in lumbar pain starting shortly after first dose. So far other bone Mets seem to not be too bothered by it. So you are moving on to Docetaxel as your next treatment? I could still give Zytiga a try before chemo if Lu doesn’t work, but they say once you fail one of the 2nd gen adt drugs, chances are only about 10% any of the others will work

[Fightinghard in reply to joeguy]

i already ran the course with Xtandi. Worked great for about 20 mos.

[RyderLake2]

Hello from a fellow SPLASH participant,

The participants on this forum are all cheering for you. Hope you have better results with your second infusion. Fingers crossed.

[joeguy in reply to RyderLake2]

hey fellow Splasher,

I hope you were a good responder. How long before you saw a Benefit from the Lu ? Where did you participate in the trial ?

[RyderLake2]

As the old song goes “Splish, Splash I was taking a bath!”

I live in British Columbia, Canada. There were only ten men approved for this trial in BC. I am one of them and the very last one chosen. I consider myself very lucky to have been accepted. I did not get into the Lutetium arm but I am not all that disappointed. As part of the trial they took me off Xtandi which I have been on for five and a half years and switched me to Zytiga. That is not currently permitted by our provincial health care system which pays for all drugs. The trial also allows for a crossover to Lutetium if Zytiga fails. You have to like that!

For me personally, I am quite happy. I now have two steps between me and chemotherapy, Zytiga and Lutetium. The SPLASH trial is being run by the BC Cancer Agency in Vancouver. Good luck JoeGuy and stay in touch!

[joeguy in reply to RyderLake2]

thanks Ryder,

There are 9 of us in the Dallas trial, and I also feel extremely lucky to have gotten in.... I think I am number 8.... hoping for the best for all of us

[RyderLake1]

Hi JoeGuy,

If this trial is successful it is going to open the door to Lutetium for thousands of men world-wide who are looking for an option to chemotherapy much earlier in their treatment plan. The two of us, along with everyone else in the SPLASH trial, are making an enormous contribution to medical science. My wife and I are knocked out by the care, attentiveness, and professionalism we are receiving from everyone at the Cancer Agency. Good luck and keep us posted.

[joeguy]

I agree, treatment in the trial at UT Southwestern has been excellent. Will post next month after scans and round 2 of Lu.