Are PSMA negative mets usually castrate resistant?

[V10fanatic]

I had 2 clear PSMA-PETs (at a PSA of 2 & then 4) so Dr. Scholz recommended I get an FDG PET. Low and behold 3 decent sized mets showed up. In my subsequent research it seems like all the published articles describe the PSMA negative mets as being castrate resistant. Zytiga/Lupron was effective before my current ADT holiday. Is it possible that I could have become castrate resistant while on the vacation? I guess I'll know for sure once I get back on the ADT.

[Tall_Allen]

PSMA expression is independent of castration resistance. All Pluvicto-treated men in the US are castration-resistant and express PSMA. About a third of castration-resistant men are discordant - some of their metastases do not express PSMA.

[Seasid in reply to Tall_Allen]

Thanks for the information.

[anony2020]

They are now testing a new drug that is more powerful than all the generation 2 agents. Forget the name.

Also FDA has approved testing polio virus against cancer. It seems to be effective against many types including prostate.

Dont mind me. I am a layman. 😊

[V10fanatic]

I found this TA info helpful with my situation. prostatecancer.news/2019/12... In speaking with my MO Dr. Scholz last week, he recommended that I add chemo to the ADT/Zytiga/SBRT/Xgeva mix asap.

[V10fanatic]

"Among different disease stages, PSMA-FDG+ disease was rarely detected in the hormone-sensitive cohort, but frequently found in the castration-resistant cohort." Discordant disease appears to have a worse prognosis.

This quote came from this study- aacrjournals.org/clincancer...

[V10fanatic]

On some one else's post Tall Allen hyper linked this study

euoncology.europeanurology....