Waiting time for Xofigo after failed Lu177 PNT2002 ?

[Ollie1948]

On the day before my 3rd infusion of Lu177 PNT2002, my bone scan shows increase in size of my old mets and numerous new mets. It is obvious that the Lu177 didn't work in my case. Meanwhile the PSA kept rising from 23 to 41 in 4 weeks.

On, 3-21-23, I have declined the 3rd shot of Lu177 PNT2002. I kicked myself out of the trial. A new Liquid Biopsy was order to ensure and no mutation change.

On 4/19/23 I was seen by the trial MO to confirm the previous recommendation of 10 sessions of of Docetaxel after the new liquid biopsy confirmed the first one with no mutations. Meanwhile, the PSA has risen to 115.

The MO answering my question about Xofigo before Chemo, replied that I would need 6 months wait after the last shot of Lu177. So far all mets are at the bones.

6 months even after only 2 shots of Lu?

[Tall_Allen]

I suspect it is safe. There were a few small studies of Xofigo first followed by 177LuPSMA:

jnm.snmjournals.org/content...

ncbi.nlm.nih.gov/pmc/articl...

mdpi.com/2072-6694/14/3/557

I don't see why it wouldn't be safe the other way, especially if your bloodwork is good. It's certainly worth a discussion.

There's even a clinical trial in Melbourne using both at the same time:

clinicaltrials.gov/ct2/show...

[Hidden]

You were in a trial. Did anyone confirm you were not getting the placebo?

[Ollie1948 in reply to Hidden]

no placebo in this trial

[john4803]

Sorry, to hear of your results! I just got my 2nd LU177 infusion last week but don't get scans or a PSA update for 2 more weeks. I am in the Eclipse trial at St. Louis U Hospital.

Best of luck going forward!

[SViking in reply to john4803]

i’ve just been excepted in the eclipse trial also. Could you describe your experience so far? Do they isolate you after your injection and so forth?

[Ollie1948 in reply to SViking]

A EKG after the infusion and ready to leave.

[john4803 in reply to SViking]

Actually, it is quite relaxed. My wife stays in the room with me. We can leave the door open, if we wish. The Doc., Nuclear Tech., & nurses don't wear any protective clothing. The Nuc. Tech wears a dosimeter. I have a restroom that I am only to use. We have a TV to watch, if we want.

They start an IV with a saline drip & an anti-nausea drug, for 15 minutes & then inject the LU177. They then observe me for an hour, taking vital signs every 30 minutes. After that we leave & head home.

[SViking in reply to john4803]

thanks. Do you fly or drive home? I thought we were not able to fly for a few days because of airport security.

[john4803 in reply to SViking]

I drive home. It is about an hour's drive.

I got a card for "Security personnel and law enforcement notification. .... has undergone a nuclear medicine procedure involving a small amount of short-lived radioactive materials. The residual radiation may be detectable externally." Don't need to carry the card after 10 days.

One is supposed to stay 3' away from everyone for 2-3 days & 10 days for pregnant women & children under the age of 10. So, don't know how this works for air travel?

[j-o-h-n in reply to john4803]

I'll pay you to stay next to my ex-wife for at least three days....(if you can stand it)...

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 04/24/2023 8:12 PM DST

[john4803 in reply to j-o-h-n]

She will probably succumb to natural death before this level of radiation gives her cancer. Maybe if you could get a group of us surrounding her? 😜😆I think that is why they are more concerned with the very young!

Sounds like you miss her a lot? 👍

[j-o-h-n in reply to john4803]

Actually I've missed her 3 times, she keeps bobbing and weaving.....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 04/24/2023 8:51 PM DST

[MateoBeach]

I would think that if your blood counts have recovered to near pre treatment levels it would be okay to proceed with Xofigo.

[u302000]

ollie,

check out the Clinical Trial of the new targeted chemo Vobra Duo. It searchs out B7-H3 protien on the cancer cell rather than PSMa and delivers the chemo directly to the cancer cell. Check out my recent post and link to Dr Shore presentation.

Cheers,

Buddy