Pluvicto

[TheDude90]

Does anyone have any experience with this drug? Relative is in his 70s and has bone metastases in the pelvis, but has not spread beyond that. Has gone through chemo which helped and other treatments but cancer is still growing slowly. Still walking around but fears being bed bound, losing lots of weight. Is this drug just going to have him feel miserable while delaying the end? Any exoeriences?

[Miccoman]

I have the same questions.

Also, in the literature provided to me by my Radiation Oncologist, from the manufacturer, it is effective around 30% of the time!

Considering the isolation after treatment that is required, potential side effects (especially try mouth from attacking saliva glands) and that often results don't start until after 3rd treatment (from what I've read on here) I'm taking the decision very slowly.

[Poowater in reply to Miccoman]

Look for Lutetium 177 on this site. There is much information.

[Tall_Allen]

I suggest getting an FDG PET scan too to make sure it is worthwhile.

[tango65]

It is effective if patients are correctly selected.

The metastases should express PSMA and they should have a SUV value around the SUV value of the liver.

Ideally it should not be metastases without PSMA expression since they will not be treated by Pluvicto. This could be determine doing a 18F FDG PET/CT.

If there are many bone metastases , patients with diffuse infiltration of the bone marrow may have severe complications caused by depression of the bone marrow.

These patient perhaps are best treated with a combination of Lu 177 PSMA and Actinium 225 PSMA or only with AC225 attached to the ligand J591 (there are clinical trials).

It seems that Lu 177 PSMA may be more effective if the patients are treated early in the disease process. (there are clinical trials for castration sensitive cancer).

It is very effective in patients with lymph nodes mets only.

I had many lymph node mets and only one treatment done in 2016 took care of all mets according to many PSMA PET/CTs done along the last 7 years. GP24 had a similar experience.

It should not be used in patients with a low volume of mets since most of the Lu 177 PSMA will go to the salivary glands, the kidneys and the small gut, causing xerostomia, nausea, diarrhea and it may damage the kidneys.

[Chask]

I have now had 3 sessions of Lutetium. I have had virtually NO side effects. Bit of minor fatigue for a day or two. That compared with chemo (docetaxel) which was a nightmare for me. After 3 sessions my PSA has reduced from 836 to 40. I have extensive mets throughout scapula, spine, ribs, pelvis, femur etc. Scans show these reduced by about 50%. I have never had pain so cannot comment on that.

[Fightinghard]

great results for some people. For me it helped a lot for first 2 doses. Between 2nd and 3rd dose caused severe bone pain in spine ribs hips. Psma scan before dose 3 indicated many lymph nodes had resolved but bone mets increased. After 3rd dose, bone pain severe and hemoglobin levels very low. MO decided to stop Pluvicto and switch to SOC Chemo treatment.

As was mentioned, salivary glads can be impacted causing dry mouth, but more serious potential risk to kidneys and bone marrow.

While it was limited help to me, if the MO supports it, I would try the LU since some have had great improvements.

If not already in place, ask his MO about adding low dose (10mg) daily prednisone. It can help reduce the bone inflammation pain and some studies show it can even slow rate of progression. Should help with appetite too.

Don't be discouraged. After metastasis, Nothing stops this beast, best available known treatments can slow it down, or cage it up for awhile. Thats the best you can reasonably hope for.

Good luck to your relative and hope he finds some relief and can get back to enjoying life.

[JoeyDad]

Dude - I’m 77 and have been dealing w PC since 2012. My Gleason is 9. I’ve had all the hormone drugs and other meds to stop cancer growth. Then I’ve had docetaxel and cabazitaxel. My bone Mets have been hurting and I have had 1 infusion of Pluvicto 3 weeks ago. Pain now managed w Tylenol, if anything. I get fatigued but so far, everything has been ok. My PSA was 27 when I received the Pluvicto. Will get an update in 3 weeks.

Good luck with your situation….hopefully we both improve!

[Yank66]

Hubby just had second Pluvicto infusion with what looks like success. PSA is down from 194 to 69 after the first treatment. He has been careful to stay well hydrated to protect kidneys and salivary glands. Side effects have been minimal-mild nausea twice, a little fatigue several days after treatment. But the hope it has given both of us is priceless.

[Biobro]

I'm with Chask on this. Spouse is diabetic and has aggressive metastatic disease. Every treatment prior to Pluvicto was awful and failed quickly if it worked at all. ADH depression, Docetaxol crippling neuropathy, hyponatremia etc. His psma pet scan lit up like a Christmas tree, so he went in knowing he was a good candidate. Apart from bone pain a few days following infusion (easily managed w meds) and dry mouth (suck sour lemon hard candies during infusion and a couple of days afterwards), this has been a breeze for him. He's half way through the treatment and is back to leading a normal life. If it works for you, it is a miracle treatment.

[Biobro in reply to Biobro]

Forgot to mention, the 3 days distancing is no problem at all. We just avoid getting close to each other and he stays clear of children for 6 days and anyone who might be pregnant for a bit longer.

[Ollie1948]

I have completed 4 weeks ago the second infusion of Lu177 PNT2002. Minimal side effects other than some fatigue a few days after each infusion. Meanwhile my PSA went up by doubling since the first treatment, from 16 to 30. Probably I will be kicked out of the trial.

[john4803 in reply to Ollie1948]

I am trying for the Eclipse trial & they told me that at least after the 1st infusion, PSA may go up because of dead cells? Not sure after two, however? Best of Luck!

[Biobro in reply to Ollie1948]

According to spouses's MO and his RO, PSA during treatment is not a marker for success with LU177. There is often significant PSA flare with cell apoptosis so don't read too much into a PSA increase at this stage.

[leebeth]

My husband had 4 doses of Pluvicto. He had no side effects; in fact, he felt clinically better. Unfortunately it could not keep up with the sheer volume of disease and now he is receiving Ac-225. He used a separate bathroom for the first 72 hours. Really no other restrictions. We shared the bathroom in the hotel room and he just followed the guidance: sit to void, close lid prior to flushing twice, and wash hands for a full 30 seconds.

My brother has had one dose. He is 82. He tolerated it well and his PSA dropped from 120 to 40 in just 3 weeks. He feels better than he has felt in months.

[CAMPSOUPS in reply to leebeth]

You and he have been thru a lot. I'm glad or it at least it appears the earthquake did not delay his Ac-225 tx. I hope it is very beneficial for him and that you both can get some quality time.

[leebeth in reply to CAMPSOUPS]

Thank you so much. The epicenter was quite far from the hospital and they haven’t been affected.

The past few weeks have been tough. He is supposed to go back at the end of March and I am not sure he will be strong enough. Scan is March 14, so we will have a better idea.

Luckily, our daughter is able to work remotely so she has been here to help us Plus she gets to spend time with her dad He tries harder for her, and eats a bit more His appetite has been an issue

[Cancerfreebruce]

I do not know that drug at all. I was diagnosed a little over a year ago with stage four with bone Mets on pelvis and a couple smaller spots on each lung. Did chemo and androgen therapy. in addition I added the Joe Tippens protocol . I am now in complete remission with no signs of ever having cancer. Look up his story and many others on Get busy Living. I did lots of research before trying the protocol. It has given me a new lease on life. I hope it has similar results for you if you give it a try. There are now several universities researching it, it is no joke and I believe it will save many thousands of lives. With cancer throw everything you’ve got at it!

[RusLand]

Hi! Look for this information on my page by clicking on my nickname. I have described my experience of PSMA therapy in great detail in a series of publications on this forum. This is the same regardless of which therapeutic isotopes the PSMA ligand will be loaded with! It is possible that you will find the information you need there, especially the one concerning the strict selection criteria for this treatment! And God bless us all!