Preparation for Pluvicto (LU177) in the UK

[Finlay66]

Hi

I'm seeing my Oncologist on Friday.

Please can someone remind of the two scans you should have to determine if the treatment is likely to be effective?

Many thanks

[Benkaymel]

Hi, you need a PSMA PET scan and an FDG PET scan to compare and check how much of the cancer is/is not PSMA avid.

I assume you're having the Pluvicto privately self-funded - where are you having it?

[Finlay66 in reply to Benkaymel]

Thank you all for your advice and comments.

I have been through the Enzalutamide, Docetaxel, and RA 223 pathway. So I guess after Cabazitaxel, LU177 is the last chance saloon. I read there is a chance of a NICE announcement in November but it's hard to know if this would be positive.

So my approach is to start to prepare for LU177 by getting early scans. Self funding of the whole treatment is certainly possible but not preferred at nearly £80K in the UK, based on current commercial prices.

[Benkaymel in reply to Finlay66]

Yes, NICE are scheduled to make a decision on 15 November as to whether Lu-177 will be funded on the NHS after 2nd gen hormone therapy and chemo have been completed. Fingers crossed 🤞

[Ian99]

Hi. From the material I could find they use 2 types of scans to check you have PSMA+ mets:

-PSMA PET-CT

-Pylarify PET-CT

This is of interest to me also but I’m no expert on the topic. You may get more input. But as your meeting is tomorrow, you can at least explore these scans with your MO. Good luck.

[Justfor_ in reply to Ian99]

Pylarify is a trade mark name of PSMA PET/CT, so the two are actually one. The correct response to the OP's query has been given by Benkaymel.

[Ian99 in reply to Justfor_]

Thanks

[Ian99 in reply to Justfor_]

Further to these scans.. if mets show up on both scans, what result or ratio would be deemed sufficient to make Pluvicto worthwhile ?

[Justfor_ in reply to Ian99]

I don't think the jury is out on this. The "sure" bet is that FDG should show nothing while PSMA is avid enough, if memory serves, north of 15, the higher-the better.

[Finlay66 in reply to Ian99]

Interesting question.

[Tall_Allen]

You will be required to get a PSMA PET/CT, but I think it's also prudent to get a FDG PET/CT for the reasons discussed here:

prostatecancer.news/2019/12...

[Finlay66 in reply to Tall_Allen]

Thank you Tall Allen.

[Finlay66]

Thank you all for your advice and comments.

I have been through the Enzalutamide, Docetaxel, and RA 223 pathway. So I guess after Cabazitaxel, LU177 is the last chance saloon. I read there is a chance of a NICE announcement in November but it's hard to know if this would be positive.

So my approach is to start to prepare for LU177 by getting early scans. Self funding of the whole treatment is certainly possible but not preferred at nearly £80K in the UK, based on current commercial prices.

[j-o-h-n]

Holy Shit, 80,000 Pound sterling equals 97,576.00 United States Dollars.

Man! You can buy a whole lot of fish and chips for that kind of money.........

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 09/29/2023 7:17 PM DST