Chemotherapy or Pluvicto

[Islandboy2021]

I just completed Radium 223 treatment. PSA has been doubling since I failed Zytiga. Last scans show progression. I am offered chemo or a trial with Pluvicto. The cancer is throughout my bones. What should I do. I have had chemo at the beginning of this journey and it worked then.

[Tall_Allen]

If you have to choose between second chemo or Pluvicto, this trial suggested Pluvicto may be best next.

prostatecancer.news/2020/05...

[RyderLake2]

Hello,

I would go with Pluvicto. Two things to keep in mind. First, you have to have a PSMA PET scan and this has to indicate you are PSMA avid. Otherwise, Pluvicto (Lutetium) is not going to work. Secondly, Pluvicto does not work with all men. For 1/3 of men who take the full treatment the results are amazing, for the next 1/3 the results are so-so and for the last 1/3 it doesn't work at all. Then again what have you got to lose? Good luck!

[SeosamhM in reply to RyderLake2]

Very well put and seconded: Pluvicto. You can choose the non-targeted systemics later (rechallenge with a taxane, or move on to a platinum-based chemotherapy).

[j-o-h-n]

It it pronounced Caribbean or Caribbean?

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 10/08/2023 6:11 PM DST

[Leps]

Go with the Pluvicto. I'm in the one third where it's working well (PSA 89.4 to 14.7 after two doses), and the only side effect has been some dry mouth. Compared the chemo, Pluvicto has been a walk in the park for me. And you can do chemo later on. Good Luck!

[Islandboy2021]

Thank you all for the great feedback. I have never had a PSMA PET scan. The Pluvicto is only offered in a trial here in BC Canada. It’s in Vancouver and I have reached out to them. I will get the Oncologist to set up an appointment. I just had my last radium infusion last week. Having CT and MRI scans this week. I am also going to get a couple of painful spots on my ribs radiated. I had my first serious pain event a couple of weeks ago. I guess this is what I can expect going forward with this disease.