Pluvicto does not work better if used before docetaxel in mCRPC

[Tall_Allen]

More information on optimal sequencing - it doesn't matter which is used before the other in chemo-naive men who are metastatic and castration-resistant (mCRPC).

prostatecancer.news/2023/09...

[Vishwa1890]

My father had 5 cycles of Pluvicto after docetaxel failure. PSA came down to a minimum of 15 from 100 after 4 cycles. But, it increased to 85, 1 month after 5th cycle and 269, 2 months after 5 cycle. We stopped now.

Consulted a different MO yesterday. His words are not encouraging. He is saying its almost the end of the road. I still think Carbazitaxel is a good option. He currently suggested to try out Enzalutamide and see how far it takes, before going for another chemo.

My 77 YO father is clinically doing OK, but mentally stressed after recent developments. I am worried and confused at this point.

[Tall_Allen in reply to Vishwa1890]

Maybe combine enzalutamide with chemo, as in this trial:

prostatecancer.news/2022/10...

[Vishwa1890 in reply to Tall_Allen]

Thanks Allen. We will discuss this with MO.

[MiRob]

interesting but isn’t this assumption based on a quite small study?

[Tall_Allen in reply to MiRob]

💯 As discussed in the article.

[Medline]

Docetaxel does not affect PSMA expression [pubmed.ncbi.nlm.nih.gov/195...], but Enzalutamide increases PSMA expression [pubmed.ncbi.nlm.nih.gov/354...]. Interestingly, the active form of vitamin D decreases PSMA expression [pubmed.ncbi.nlm.nih.gov/182...].

[bglendi53]

I've completely lost faith in Pluvicto and have stopped after 5 sessions. My PSA did nothing but go up, and now I'm extremely anemic.

[j-o-h-n in reply to bglendi53]

I post again regarding Pluvicto................Most of the posts for Pluvicto on HU are negative..... In light of these many criticisms regarding Pluvicto, I thought we should treat it like an 8 letter curse word.....

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 09/22/2023 4:41 PM DST

[Tall_Allen in reply to j-o-h-n]

LOL. It works really well for about a third of the people most of the time.

[MrTeebs in reply to bglendi53]

hasn’t worked for me either

[j-o-h-n]

Then 5.33333333333% = letters of the word Pluvicto is a curse word..(okay software guy, place a grinning emoji here X and to you too, you lazy prick)....

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 09/22/2023 8:19 PM DST

[robert570]

Pluvicto completely failed for me and doubled my PSA after each treatment. I stopped it after 3 infusions. I would put this in the "rarely happens" category because it wirks for most men.

[MrTeebs in reply to robert570]

Mine doubled as well

[Brysonal]

interesting. I still don’t think anyone has trialled the 3 Pluvicto plus 3 Docetaxel that I had when first diagnosed with mets. ) i.e at same as starting ADT.

[Tall_Allen in reply to Brysonal]

What did that do to your bone marrow/bloodwork?

[Brysonal]

Both red and white blood cells were low for 2 years but improved every month taking 2 years to hit norms again. With such a lot of treatment I don’t know what cause what, I worked throughout, commuted for the treatment overseas, went to the gym. The football, skied etc. all bloods normal atm though.