Adaptive dosing: very promising results with Enzalutamide + Lutetium

[Maxone73]

urotoday.com/video-lectures...

[Rolphs]

Very encouraging that Enzo and Lut in various dosing extends survival. Especially for some hormone sensitive patients 2 doses can extend use of ADT. I will pass along to to MO.

Thanks!

[Justfor_]

Welcome to the club! Second year anniversary for me on Bicalutamide adaptive dosing.

[lcfcpolo]

Brilliant video. Really helpful if you are still hormone sensitive or castrate resistance. Yet again the Aussies ahead of the curve here. Not even said thru my English gritted teeth.

[Maxone73 in reply to lcfcpolo]

G'day to you mate! 😜

[lcfcpolo in reply to Maxone73]

Made me laugh out loud. Thanks for posting. This is something we should all watch.

[Cactus297]

Thank you!

[swwags]

No Joke. for these old ears, closed captioning was required. I couldn't understand half of what she said.

[Maxone73 in reply to swwags]

I read the transcription below the video!! 😜

[PCaWarrior]

We randomised 162 pts from Aug 2020 to Jul 2022: median age 71 (range 45-96), prior docetaxel in 54%, and prior abiraterone in 13%. Imaging screen failure rate was 18% (40/220). 16% (13) of pts received between 2-3 doses of LuPSMA and 81% (67) received 4 doses. The median follow up was 20 months (IQR 18-21). PSA-PFS was longer with ENZA+LuPSMA vs ENZA-alone (median 13 vs 7.8 months; HR 0.43 [95%CI 0.29-0.63], p<0.001). PSA50RR and PSA90RR were higher with ENZA+LuPSMA vs ENZA-alone: 93% (77/83) vs 68% (54/79) (p<0.001) and 78% (65/83) vs 37% (29/79) (p<0.001) respectively. Analysis of rPFS (ongoing) will be presented. SAE were reported in 33% (27/81) of pts assigned ENZA+LuPSMA vs 35% (28/79) ENZA-alone.

annalsofoncology.org/articl...

[Cactus297]

Are you following a vegan diet? I read your profile, but I wasn’t sure if you have gone totally vegan or not ….my son has gone primarily vegan and eats almost zero animal protein/products.

Thank you!

[Maxone73 in reply to Cactus297]

Hi! Apart from some fish (mostly fresh water or fat fish...like salmon, trout,...) yes, completely vegan. But I think that the key is more related to simple carbs and fat sources rather than proteins. I eat pasta like once per week now (I am italian, this goes against nature! 😆) and instead of normal pasta I use a whole grain one. The only fat I use is extra virgin olive oil basically (but it has been like that for my whole life...and it did not spare me from PCa) and the one coming from the walnuts and seeds I eat. I am very careful with insulin spikes, as if I were diabetic.

[Cactus297 in reply to Maxone73]

Your diet is very similar to my son’s. He also uses only extra-virgin olive oil, and as you said it didn’t spare him from PC. Instead of pasta, he eats mostly different types of lentils and he makes his own miso soup. His exercise is hiking and he’s going on a 3+ hour hike today before we have our vegan Thanksgiving dinner. He also eats tofu. Today we are having shrimp with cocktail sauce, but he normally doesn’t eat much that isn’t vegan..I think your diets are quite similar! And healthy! Thanks for letting me know what your diet consists of and I will tell him today at Thanksgiving dinner.I am enjoying all your posts. I told my son about the possibility that soon PC could be treated much like HIV. 👌👏👏👏!

PS Are lentils a good choice? He eats a variety of them and buys them dry, and cooks them all himself from scratch.

[Maxone73 in reply to Cactus297]

All legumes, even canned (but no added sugar!) are a great choice. I am going to add homemade water kefir as well. I want to keep my gut in shape to fight everything else that might happen. One fight at a time is enough, let’s concentrate on cancer!

[Cactus297 in reply to Maxone73]

Spot on! Thanks!

[Ian99]

Thanks again for posting. This concept of adaptive dosing strikes me as a creative way of limiting toxicity. Am unsure how easily it could fit within the structure of a public health service, may require private treatment. Definitely worth considering.

[Justfor_ in reply to Ian99]

Limiting toxicity is good, but not the strongest point in adaptive dosing. Control of the different cancerous clones is the prime benefit. In the mentioned study, Enzalutamide drives into extinction the majority of HS clones, hence, bringing into the surface the resistant ones which the Lutetium later takes care of. It does make sense although I follow a different approach. Keep the population of the HS clones low, but NOT extinct, so that the resistant ones have to fight against them for dominance.

[Ian99 in reply to Justfor_]

Many thanks for this explanation.

[GreenStreet]

Thanks very much for posting. Really interesting and encouraging. However we wont be able to get this combo on NHS unfortunately and would need self funding

[MikeMartin in reply to GreenStreet]

Did they tell you the cost?