3rd Pluvicto update

[FionaElbourne]

My husband had his 3rd Pluvicto treatment last Friday, he could only get an 80% infusion because his platelets were low. Today the consultant sent us a report confirming his PSA has fallen from 362 to 115 since starting treatment in April, but the CT scan post treatment showed extensive tumours spreading throughout the skeleton. Has anyone else experienced this. It’s not sounding good but the consultant is very positive about the PSA dropping. We are now waiting on a bone scan to give a more detailed view of the bones.

[Tall_Allen]

He may want to get a biopsy of the new tumors.

[FionaElbourne in reply to Tall_Allen]

Thanks what would we be looking for in a biopsy of the bone tumours. I am not aware of him ever having a biopsy apart from the prostate tumour. Thanks

[Tall_Allen in reply to FionaElbourne]

They would do histology, IHC and genomics, looking for something treatable or that opens him to a clinical trial.

[FionaElbourne in reply to Tall_Allen]

Thanks will ask about this.

[Proflac]

Sorry to hear about the CT results. But hood news re the PSA. Did he do an FDG CT scan as well as the PSMA scan before starting the Pluvicto? Seems this is not routinely done in many places. I too am in the UK and might be looking at this route before too long.

[FionaElbourne in reply to Proflac]

Yes we had both before starting.

[SeosamhM]

I have a similar outcome with Pluvicto - while my PSA dropped as some tumors shrank, others have grown. I have radiation scheduled in two weeks for the one in my scapula that grew extensively. Likely, this is a result of tumor heterogeneity - the tumors that don't express PSMA have taken advantage of the lack of competition. Curiously enough, my scapula tumor DOES express PSMA and should have shrunk. It suggests that different PCa tumor types live side-by-side. Clever little buggers.

I did a blood "biopsy" for genomics - while there are obvious genetic deviations, they are not yet characterized in research like BRCA. And I don't have elevated blood tumor markers - which is relief. Whatever is happening in me, it seems to be largely local, i.e., the tumors were already there and simply growing.

[FionaElbourne in reply to SeosamhM]

Thank you that is very interesting . I will certainly discuss this with the oncologist.

[SeosamhM in reply to FionaElbourne]

I know it isn't particularly helpful, but like you said, "interesting." My wife and I were disappointed, to say the least.

[FionaElbourne in reply to SeosamhM]

Thanks we feel exactly the same. We had high hopes for this drug.

[MyDad76 in reply to FionaElbourne]

What about adding Ac-255 for next treatment? It seems that some get good results - seems especially the case if bone mets are present.

cureus.com/articles/112714-...

[FionaElbourne in reply to MyDad76]

I will certainly discuss this with the consultants. Thanks for replying

[john4803 in reply to SeosamhM]

What type of radiation are you having, ie., 5 treatments over 5 weeks or cyberknife, over 2 weeks?

[SeosamhM in reply to john4803]

Hey, John! High dose focused radiotherapy over 5 days. I literally just got out of my 3rd!

[robert570]

I had to stop after my 3rd infusion. I started with a PSA of 1.95 and now after the 3rd it stands at 10.12 Very disappointed. Just remember that not everyone is the same, but this drug messed things up a bit. My platelets and WBC are low too.

[FionaElbourne in reply to robert570]

Thankyou, my husband also has low platelets and WBC. Have you started a different treatment after Pluvicto failed to work for you.

[robert570]

I'm seeing the doctor on Monday August 14. Right now I'm on nothing. I can tell you that I have had numerous types of treatments and I'm down to finding a clinical trial.