Jevtana and LU177

[Finlay66]

Hi

I have been offered Jevtana after a course of Ra223.

My Oncologist says the chance of it working is just 20% and seems reluctant. Does anyone have any positive stories of Jevtana success.

Also is true that the time gap to LU177 is 6 months?

[Tall_Allen]

They are following the VISION trial protocol of 6 months after Xofigo.

[Finlay66 in reply to Tall_Allen]

Thank you. Do you have a view of the likely success rate of Jevtana?

[Tall_Allen in reply to Finlay66]

It was approved because it usually works after Taxotere fails.

[Finlay66 in reply to Tall_Allen]

Which raises the question as to why my consultant was reluctant?

[Tall_Allen in reply to Finlay66]

You'll know if it works when he tries it. Your mind is just spinning in circles until then.

[Finlay66 in reply to Tall_Allen]

ok thanks. Good advice.

[FionaElbourne]

my husband had Jevtana after Ra223 it kept the PSA static he had 10 cycles as soon as it stopped PSA jumped up. He is now having Lu177 but we only waited 3 months in between, and it took that time to arrange the PSMA pet scan and get a new Oncologist in London to agree he was a good candidate for it. We are in Scotland and LU 177 wasn’t available here.

[Finlay66 in reply to FionaElbourne]

Hi Fiona

Thanks for this. When you say you waited 3 months was that after the RA 223 or after the Jevtana? Also who was your London oncologist?

I kind of feel my Oncologist has given up on me and view its only as terminal now, which is extremely disappointing.

[FionaElbourne in reply to Finlay66]

The cabitaxel came before Ra223, LU 177 was exactly 3 months after the Ra223. Our Glasgow consultant told us we had run out of options on NHS but he suggested Constantine Alifrangis at the Wellington Hospital in London. We are paying privately for the LU177. It’s been a tough 3 months, after the 1st treatment my husband had internal bleeding for 4 weeks and needed targeted radiotherapy plus several blood transfusions. The 2nd went well until the bone pain started 6 weeks later, plus the third LU177 has been delayed due to production issues at Novartis. He is scheduled again on 4th August but bloods are not recovering so likely another transfusion next week. On a positive note the PSA is down from 360 to 135 so something is working but bloods taking a pounding.

[Finlay66 in reply to FionaElbourne]

Thanks for this honest assessment. I will look this guy up as it does seem I might be near the end of the NHS road. Maybe we will hear from NICE soon? I wonder if the long delay means they're in negotiations Novartis although the shortages are a clearly a problem. My PSA after Ra223 is 800 which is ridiculous!

[FionaElbourne in reply to Finlay66]

Our consultants told us they are lobbying for it to be approved, but at the moment the cost vs success rate wasn’t good enough. We were hoping to start off privately and switch to NHS, but not looking likely. The most successful treatment my husband had was Docetaxel but that was 8 years ago, his PSA fell to 1 from just under 500.

[Poppi07]

my dad had 3 or so months after jevtana befor changing treatments. Haven’t progressed to Lu 177 yet we are doing chemo rechallenge

[Finlay66]

Thanks Poppi. Are you doing a chemo rechallenge with Docetaxel and are you combining it with any other therapies?

[Marit85 in reply to Finlay66]

I am curious about this too. Our MO says that after failing Jevtana there is no point in rechallenge with Docetaxel due to cross-resistance. I have however seen a few on this forum that have gone back to Docetaxel, even after Jevtana, also in combination with platinum based chemo.

[Poppi07 in reply to Finlay66]

He’s going back to carboplatin and etoposide but it’s been 5 years so hoping he gets a response. I hear chemo can also have a 50/50 chance of resensitizing cells to rechallenge adt.,..