Lu177 and SIR-Spheres

[Djangler]

I'm PSMA avid with advancing mets in my liver. I'll be starting Lu177 soon, but it doesn't have a great track record with liver mets. I've seen some small group and individual case studies that show promise for treating liver mets in PC by combining Lu177 and SIR-Spheres. My oncologist is conservative and likes RCT proven therapies. I do too, but I don't have time to wait for one on this combination.

Does anyone have additional info on this treatment combo that I can share with my MO?

[Tall_Allen]

I suggest you get a second opinion from a medical oncologist who specializes in liver cancers. My understanding is that it can only be used in certain cases.

[GP24]

In this study they combined Lu177 and SIRT. They achived about 50% longer OS.

jnm.snmjournals.org/content...

You can zap these mets with Cyberknife too. Maybe you can get this done before the SIRT and achive an even longer OS. "I don't have time to wait" - I agree.

[Djangler in reply to GP24]

I've seen that study, Looks like they use SIRT sequentially after completing Lu177. Only four patients. I also saw a small study that added SIRT to Lu177 for patients who showed hepatic progression on Lu177 alone (can't find that one now). Wondering if there's any other work.

[Rrrspc]

Does it have sense in case of mHSPC?

[Djangler in reply to Rrrspc]

In the USA, Lu177 is only approved for mCRPC. I think they're doing studies to see if it's useful in HSPC.