Further advice please

[Univs]

As mentioned in an earlier post, I will be entering into deliberations this coming week with my oncologist and our Nuclear Medicine Team to determine my next therapy steps. As previously noted, I am currently on Cabazitaxel which is suspected to be failing due to rising PSA after three cycles. Options on the table for discussion this week include Carboplatin, Radium 223 and Pluvicto (BTW, Pluvicto is "currently" not available in Ottawa Canada and is also not currently funded resulting in a patient price per dose of 27 thousand $).

My question: Do Forum Participants have experiences/advice with respect to Radium 223 that they are willing to share/provide e.g., pros, cons, side effects, successful outcomes, recommendations.

Thank you. This forum is of great value!

[Tall_Allen]

Here are combinations with Xofigo that seem to work:

prostatecancer.news/2021/02...

[Univs in reply to Tall_Allen]

Thank you .....will include in my discussion prep!

[Univs]

Even at the current price tag of $27,000 x 6 doses?

[noahware in reply to Univs]

Hey, that's a bargain price... I read that in the US the cost is $42k / dose, and that is a wholesale cost even before the markup and service costs of the provider.

Good luck to you with finding the next treatment... I am post-Pluvicto and now considering Ra223 as well, because Pluvicto did not reduce my mets and PSA and ALP are now rapidly rising. But I have yet to try chemo. Also on the table is BAT, which I suspect would be hard to get a doc to try within the Canadian system.

[Univs in reply to noahware]

Thank you for your response. You gave me some good ideas to follow up on. I'm meeting with the Nuclear Guys tomorrow who seem keen on positioning their products. Have been given a 2 hour consult (question answer only). Your right about the bargain basement prices for Pluvicto here in the Great White North. No idea how anyone makes money! Keep in touch and thx!

[Fightinghard]

tango- . Univis is in Canada. In the US Pluvicto after chemo is approved and covered by medicare. IF you can even find any!!

[Univs in reply to Fightinghard]

Thx Fightinghard. You are correct. Where I live Pluvicto is approved but not covered (yet) by our health plans and furthermore is currently not available.

[tango65 in reply to Univs]

I am sorry Univs I thougt I was responding to a different post.

[Concerned-wife]

my only experience is reading about it and saving links. Here is one urotoday.com/video-lectures...

[Univs in reply to Concerned-wife]

Thank you so much. That was very helpful!

[MateoBeach]

I don’t see any scan reports in your profile. If you have predominantly bone metastasis then favor Ra223 with Provenge, if you can get it. Pluvicto not as successful with bone mets as it is with lymph node only. If the latter then consider Lu-PSMA treatments abroad where they have more experience and overall costs may be lower. Dehli is a good choice with Ishita Sen.

BAT not appropriate with painful bone mets but otherwise a reasonable consideration. Check on available trials.

[Univs in reply to MateoBeach]

Thank you......Good points. Will follow up. Thank you!