Xofigo & Ac- 225 After failed Lu-177

[Rahul_Patel]

Hi All,

Greetings!!

My dad has recently failed Lutetium 177.Previously he was treated with Docetaxel which helped him for 9 months.Xtandi and Zytiga didn't work at all.Cabazitaxel worked for 2 months.

Can we consider Xofigo and Ac225 now.Would they provide any benefits?

My dad is in lot of pain.Any suggestions would be highly appreciated.

Please let me know how to manage his pain.

Thanks!!

Rahul

[Finlay66]

Hi I've just started Radium 225. It's not without its side effects but it could be effective, especially if the mets are mainly on the bones. Your oncologist will advise after scans and bloods. I can keep you posted on my progress. I was also advised it would help with pain and QoL.

[Rahul_Patel in reply to Finlay66]

Thank you Finlay66 for your response.I wish you best results.My father does have extensive bone mets.

Managing his pain becomes priority now .

[Tall_Allen]

Combinations with Xofigo (and a bone strengthener) seem to be especially effective and should help with the pain:

prostatecancer.news/2021/02...

[Rahul_Patel in reply to Tall_Allen]

Thank you Tall_Allen for your insights.Will discuss this with my oncologist.

[Foldem]

I finished 225 last September. I had no side effects at all. My PSA went from 800 to 90, and scans showed no growth over that period and shrinkage in some places. The protocols are much simpler with Xofigo. Just double flush, wash hands, and separate underwear to be washed separately. The injection only takes a few minutes, but your bloodwork has to be OK within a week before the treatment.

[Rahul_Patel in reply to Foldem]

Thank you Foldem for your insights.How many cycles of Ac-225 you were able to go through?

[Foldem in reply to Rahul_Patel]

I did all 6 rounds (once monthly) without difficulty. In fact my doctor and I have agreed to postpone chemo and just do another 6 rounds of 225. This probably works well as LU-177 is in short supply. I have to do chemo before Medicare will pay for the LU-177, so hopefully the supply will improve when I’m ready next year.

[patient_india]

Ac225 should help if he is a good candidate

[Rahul_Patel in reply to patient_india]

Discussed this with Ishita Sen in Fortis Gurgaon. As per them there is a crisis of AC -225 availability.It may take 6 months to be available.

[patient_india in reply to Rahul_Patel]

Many hospitals in India are doing ac225 and Lu177, atleast 10 or 15.

AIIMS has highest experience with these therapies in India.

May be worthwhile checking with these places.

[Rahul_Patel]

Sure ..I will schedule a consultation in AIIMS then..Thank you for your suggestion.

[patient_india in reply to Rahul_Patel]

Prof Bal at AIIMS is excellent, he has huge experience and many research papers on results of first Lu177 and Ac25 therapies from India. We were under his care.

He is setting up another type of alpha therapy also now, I heard.