Help! Need feedback on Pluvicto recommendation

[Sewinggam]

Quick recap - asymptomatic hubby was diagnosed with StageIVb last summer. No mutations but was already in soft tissue of brain, lungs and bones. Stereotactic radiation last July took care of two brain tumors. He has responded extremely well to triple therapy (Lupron, Zytiga, and Docetaxal). It took a while to drop, but his last PSA test was .35. Every visit it has been down since the last. (It’s high was only 9).

My hubby is still feeling fine - totally asymptomatic- and living a great life.

We go back to Duke July 6 for labs then 10th for MO. He is recommending Pluvicto.

I’m worried about trying it while my husband is still responding to Zytiga and feeling so good. I can’t find any data on use when PSA is still low and responding to ADT, though Duke says this suggested treatment is not part of the new PSMAaddtion study.

Questions -

1) Have any of you had Pluvicto while still hormone sensitive? If so, what were the results?

2) Have any of you had Pluvicto with a PSA below 1?

3) For any who’ve had Pluvicto while basically asymptomatic, how has it affected your quality of life?

Thank you!!

[Skifanatic]

I am currently on Pluvicto (treatment #2 scheduled for July 6), with undetectable PSA for the last eight months. My PSA has always been low, just 3.4 at diagnosis in 2019. I had six treatments of Docetaxel plus Carboplatin beginning late in 2022 through February. My PCa is in lymph nodes, my L3, and multiple other places. According to PSMA PET Scan in March, chemo seemed to knock it back a bit, but not the body blow we were hoping. Hence, Pluvicto. I am in good health otherwise. Doing plenty of exercise and living a full life. I don’t have the expertise of so many others on this site, but I would suggest having a PSMA Pet Scan and seeing what that shows. If enough PCa lights up, strong enough, then Pluvicto may be the best next step. Good luck.

[Sewinggam in reply to Skifanatic]

Thank you so much!

[Yank66]

DH is on Pluvicto -treatment #5 is coming up next week. His main complaint is fatigue. He is 10 years into treatments for stage 4. He’s had a drastic drop in PSA, so we’re anxious to see scans after the completion of treatments.

[Sewinggam in reply to Yank66]

Thank you! Best wishes for you and your husband

[hopefull99]

I started Zytiga in June 2022 and my PSA is now down to 0.12. My prostate tumor has not got any worse and some of my mets have actually shrunk. Side effects for me are that I have lost a lot of muscle, thining of the skin so I bruise easily and some water retention in lower legs.

[Sewinggam in reply to hopefull99]

Sending best wishes!

[Concerned-wife]

we think the witld of Duke prostate cancer doctors. They seem quite amenable to answering questions. Are they perhaps offering your husband a chance of treatment through a clinical trial?

[Sewinggam in reply to Concerned-wife]

It’s not a clinical trial, but I read in Urology Today that there is a current study on whether it’s beneficial to give Pluvicto earlier in the disease treatment. We see his doctor soon and will be asking about what they expect/hope for versus waiting, and if there is any data on it. Likely no data on Pluvicto given early, but there may be some other cancers where using similar treatment earlier had a greater outcome. I hear a lot on this forum “hit it hard, early.” This would certainly be trying that and would inform future cases. Of course, my concern is my husband.

[RyderLake2]

Hello,

Although newly approved by the FDA in North America, Lutetium-177 (Pluvicto) has been used pre-chemotherapy for a long time in many parts of the world. The nuclear medicine doctors in Germany, Australia, England, India and elsewhere have been using it for years. It doesn't work for everybody but for some men the results are incredible. If your medical oncologist is recommending Pluvicto, I would say go for it.

[Sewinggam in reply to RyderLake2]

Thank you so much!

[LongTimeRunning]

I'm early in PSMAddition. Just made the cutoff date of not being on ADT for too long (no more than about 45 days).

1) Have any of you had Pluvicto while still hormone sensitive? If so, what were the results?

PSA 49 in Feb, down to 0.16 in May before first injection. A month later (before 2nd injection) PSA measured at 0.026. My PSMA scans showed relatively low SUVMax. Hard to say if drop was from treatment or the continuing effect of ADT. PSA was dropping fast before treatment, so a good case for leaning towards ADT.

2) Have any of you had Pluvicto with a PSA below 1?

Yes, see 1). Mostly because of frustrating admin delays getting the trial started when PSA was around 8-10.

3) For any who’ve had Pluvicto while basically asymptomatic, how has it affected your quality of life?

Asymptomatic other than some drymouth 1-2 days after treatment. Yesterday I had injection #2. I also awoke with slight upset stomach and gnawing hunger. Main QOL issues are from ADT.

[Sewinggam in reply to LongTimeRunning]

So helpful! Thank you!

[Duke2021]

I’m afraid my husband passed away last February

[Sewinggam in reply to Duke2021]

My thoughts are with you ❤️