I’m at Mayo for my third Pluvicto (Lutetium-177) treatment. Yesterday, I had a PSMA Pet scan to check on progress. I’m happy to report that it’s all positive at this point in the game. I include below the “findings” on the radiology report from the scan which speaks for itself. I look forward to hearing any comments, observations or suggestions any of you have. My PSA remains undetectable after almost a year. I am still on Nubeqa and Lupron (every three months), plus Pluvicto.
FINDINGS:
PROSTATE: No focal tracer activity in the prostate to suggest residual/recurrent primary prostate neoplasm.
LYMPH NODES: Improving or resolved PSMA avid metastatic nodes above and below the diaphragm. As examples, a left periaortic retroperitoneal node is now barely discernible with decrease in tracer avidity (SUV max 4.0, previously 13.9) with other previously demonstrated tracer avid retroperitoneal nodes resolved, bilateral tracer avid common iliac nodes have essentially resolved and a right external iliac node has decreased in size from 8 mm down to 3 mm short axis with decreased activity (SUV max 2.7, previously 9.8). As examples above the diaphragm, a precarinal node has decreased in size from 13 mm down to 9 mm with significant decrease in activity (SUV max 3.1, previously 27.6), a right prevascular node is now barely discernible with significant decrease in activity (SUV max 2.7, previously 37.0), the bilateral tracer avid hilar nodes have nearly resolved, a left supraclavicular node has decreased in size from 9 mm down to 4 mm short axis with decreased activity (SUV max 3.0, previously 13.0) and the tracer avid right supraclavicular nodes have resolved. No new tracer avid lymphadenopathy.
OSSEOUS DISEASE: Decreased degree and extent of activity involving the previously demonstrated PSMA avid osseous metastases. As examples, marked decreased degree of tracer activity within the L5 vertebral body metastasis (SUV max 4.5, previously 32.7), decreased activity within the L3 vertebral body metastasis (SUV max 5.6, previously 15.0) decreased activity within the T10 vertebral body metastasis (SUV max 6.8, previously 17.3). More modest reduction in activity within the metastases in the C2 vertebral body (SUV max 8.6, previously 12.7) and within the superior right acetabulum (SUV max 3.0, previously 5.5). Previous small PSMA avid bone metastases in the supra-acetabular left iliac bone and within the posterior right acetabulum have resolved. No new tracer avid osseous metastases.
OTHER METASTATIC DISEASE: None
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Skifanatic
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So far, so good…last two treatments I had a little fatigue but that was it. I take the direction seriously to drink A LOT of water for a few days after to flush the radiation out of my body. I think that helps.
Thanks, my doctor said to enjoy this good news. Just like everyone else on this site, I know that my fortunes can change dramatically at any time so I’ll take the good news when I get it!
When first diagnosed in 2019, it was 3.4. Went on Lupron and it dropped to undetectable from mid-2020 through early 2022. Then went to .4, .5 and finally .9 in October 2022. Restarted Lupron, dropped right away to undetectable. Did 6 rounds chemo, not very helpful. PSA remained undetectable, through beginning of Pluvicto treatment in May and through today.
Thanks for the info. Just wondering what the effect of the Pluvicto was. When I started my Pluvicto treatment my PSA was 68.37, after 4th treatment (3 week blood draw) it went to 9. Next treatment is in September.
Great to hear your results! It's interesting this is happening with your low PSA. I'm in the PSMAddition trial and just had my 3rd Pluvicto infusion. The trial doesn't monitor progress with PSMA PET, just bone and CT scans, but they are showing good results (21 mm lesion in L2 vertebrae almost completely resolved, others nearly resolved, stable or "less sclerotic"). My PSA was also low (0.008) before 3rd treatment.
Best of luck on your continued progress.I had 4 treatments, but had to stop as it is taking its toll on my bone marrow with low blood counts. Also, PSA is very unstable and jumping around. Alot of fatigue, labored walking, occasional shortness of breath, low appetite. Don't believe will continue on with #5 & 6.
I’m sorry to hear that. Very discouraging considering the expectations we’ve all had for Pluvicto. I seem to read a lot more negative than positive experiences on this site so I feel extremely fortunate and grateful it’s worked for me so far.
Add my spouse for positive results on Pluvicto. He was hanging on by his fingernails when he started and it was like miracle treatment since nothing else had worked. It has given him at least a year of life. We won't know for another two weeks whether there are enduring effects, but it was only treatment he had, including adt, where the side effects were tolerable and he felt GOOD!
That’s so good to hear…what do you mean by knowing about enduring effects? Will he be getting scans, PSA test? Did he receive all six treatments? Any additional information you can provide would be appreciated by all, I’m sure.
He is getting a CT scan and a PSA test next week. RO has already told us that the they're never sure what they are looking at in the scan. In other words, they may be looking at metastices or at recovering bone. PSA at this point 8 weeks after the 6th treatment is also iffy to judge although spouse's PSA throughout the course of his disease has been a pretty good indicator of efficacity of treatment and disease progression. His PSA came down from 645 to 185 after the third infusion. Then they had the supply issues and he missed one treatment. PSA started rising just prior to the 4th one. We take it one day at a time and have learnt not to panic. When the disease starts progressing again, we'll move onto the next step which may be AC225 (in Europe or a trial in the US) since the LU177 worked so well and he tolerated it so well.
After my 3rd went from 2 to 0.1 but after 4th bumped up to 0.2. Not sure if it means anything. Getting a PSMA PET to see.
After the 3rd I started to have a burning side effect in my back int the vicinity of my old mets and new ones. Speculation is that it appears to be nerve pain and maybe from voids left over from the cancer kill and surrounding nerves being affected before bone is filled back in?
Good luck to you. I hope your results improve once you’ve completed the course of treatments. I’ve been so fortunate to be spared side effects. Just a little fatigue after first two treatments, nothing more.
Thanks this gives me a lot of hope. I just had my second pluvicto treatment and so far things are stable but no measurable difference. Not worse at least. I have a mri and ct coming up within the next 10 days so we’ll see. Best of luck!
I’m wondering what was your PSMA score (2 or 3), and how high were the SUV ratings of your cancer sites? I hope your scans are helpful and show positive direction. Good luck.
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