PSMAddition Phase 1/2 Results?

So my story seems to be evolving quickly.

Last August with, psa around 1.4, a psma pet picked up an 8 mm lesion in my right lung and nothing else. Too small to biopsy. Everyone unsure what it was.

In November my psa was stable at around 1.4 and a ct scan indicated the lesion was unchanged. Too small to biopsy. Everyone unsure what it was.

In February a psma pet showed the lesion was still 8mm but was joined by another at 10 mm and a sub 6mm lesion in my other lung.

My Psa jumped to around 1.9.

So my MO started me on casodex, scheduled me for a lupron shot and started the paperwork for xtandi.

He is trying to enroll me in Psmaddition, which if I get accepted and put into the treatment arm, I get 6 doses of pluvicto along with the xtandi and lupron

my question is

Psmaddition is a phase 3 trial. Are there results from phase 1/2 anywhere?

[Tall_Allen]

Earlier use of Pluvicto for mHSPC:

jnm.snmjournals.org/content...

aacrjournals.org/clincancer...

PSMAddition was started before triplet therapy became the new SOC.

PSMAddition has this inclusion criterion: "Patients must be treatment naïve OR minimally treated..." Will they take recurrent men after prostatectomy and SRT? Please let me know because I know another patient who is going to Germany soon for it.

[Schwah in reply to Tall_Allen]

it says “First-line PRLT was associated with the longest OS (median not reached at 55 months, all 18 patients are alive)”. What’s “First line PRLT” mean? Do you believe that hormone sensitive men should consider Pluvito in addition to lupron and Zytega?

Schwah ?

[Tall_Allen in reply to Schwah]

It means PSMA Radioligand Therapy used as a first therapy. That's what PSMAddition will determine.

[LongTimeRunning in reply to Tall_Allen]

I'm one of the minimally treated waiting to get in PSMAddition, but my 45 day clock from start of ADT to being able to get into the study is running low. Over the past month I keep getting told "we are very close to enrolling patients". My PSA was rising too fast for my comfort (up to 49) so starting ADT sooner was something I felt necessary. PSA dropped to 8 after 3 weeks so I think that was the right decision for me no matter what.

[Hidden in reply to LongTimeRunning]

I have to ask about the 45 day clock. I am scheduled for a lupron shot later this week.

[LongTimeRunning in reply to LongTimeRunning]

I got in the trial with a PSA of 0.16. ADT was working! Still, PSMA activity was found where the mets were.

[Hidden in reply to Tall_Allen]

I will certainly let you know. They had me sign consent forms last Friday, and they are going to schedule me for a bunch of tests (another psma pet, bloodwork of various kinds etc…)

[Brysonal]

when I was systemic treatment naive ( bone mets for me and rising PSA) I wanted to try Lu-177 first via PSMAddition but it wasn’t up and operating quite in uk and I needed hormone therapy shot which then set the clock ticking on 45 days to get Lu-177 so instead I did it private and out of pocket in Finland.

My belief is earlier the better for Lu-177 and the 3 infusions I had were easy and no dry mouth. I was iced at salivary glands but no idea if that helped but it was a v easy treatment( every 4 weeks in Finland)

I also started degerelix at roughly the same time so my PSA drop and impact on mets is muddy re what did what.

My private path then diverged further from PSMAddition trial as Finland said first 3 Lu-177 were most impactful and then wanted to do 3 x Docetaxel every 3 weeks.

I was very upset tbh as I wanted to avoid early chemo ( which I could get at home ( UK) as part of SOC . I did it however as I kept hearing reading about the PSMA negative cells and the cancer being heterogeneous so boy the bullet and did an unusual 3 plus 3. My scan after results are on my bio.

I was fully iced for chemo which was a painful hour! I also fasted into it and 12 hours after ( veg soup only) and it helped bring young and fit so actually was fine, kept hair and nails.

So I can’t report on PSMAddition though I chased it but I do think Lu-177 will become a first line treatment if they can sort production issues.

I did a belt and braces job thereafter as my HIFU’d prostate was still showing suspicious activity so had Vmat and brachytherapy too before I finally hit undectable PSA and a NEd scan.

No regrets starting off on LU-177 and appreciate my desire the throw everything at it is unusual so just back from a perfect ski holiday in the Alps and compared to where I was 12 months ago v grateful to the Finland plan.

[Hidden in reply to Brysonal]

Wow what a story!

[MateoBeach in reply to Brysonal]

your approach (analysis, choices and courage) are inspiring Brysonal. Glad you threw everything at it and are now doing so well. Live long and ski powder. MB

[GP24]

I had a Lu177 therapy/Pluvicto while being hormone sensitive. I described the results in this post:

healthunlocked.com/advanced...

[Hidden in reply to GP24]

I remember reading that post when i first joined here. How long ultimately did it hold the beast at bay?

[GP24 in reply to Hidden]

After a year I stopped Bicalutamide and the PSA value did rise. At a PSA value of 3.0 ng/ml I had a successfull PSMA PET/CT and then got another cycle of Lutetium 177. Since then I take Bicalutamide for maintenance and the PSA value is low.

[j-o-h-n]

Keytruda worked for me regarding my Lung metastasis from a Melanoma.....Ask Doc about Keytruda........

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/26/2023 6:40 PM DST

[GP24 in reply to j-o-h-n]

John, immunotherapy works very well for melanoma but it does not for prostate cancer. I would treat lung mets with Chemo and/or SBRT radiation.

[j-o-h-n in reply to GP24]

That's what both my Pca MO and my dermatologist MO said (but I don't believe those lying bastards).....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 03/27/2023 12:37 PM DST