PSA rise from initial Pluvicto treatment

[joeguy]

I am curious if most of you that have been through Pluvicto experienced a PSA rise initially?

I just finished my first injection, and did see a bit of a jump in PSA level.

I had a similar experience in the SPLASH trial last year. After the first Lu177 injection, my PSA shot up quite a lot. This got me kicked out of the trial for "progression", but my current onc and radiation guy seem to think a PSA spike is a sign the Lu177 is actually working.

[Ramp7]

Good question. Mine went down after first infusion. Looking forward to responses.

[PeteLG]

After First Pluvicto treatment my oncologists explained the increase as a "flair", after #2 an increase in PSA of 1100 to 4900 ... I call it "skyrocket".

Hope you medical team is correct.

[joeguy in reply to PeteLG]

Did your PSA drop after additional Pluvicto treatments?

[PeteLG in reply to joeguy]

#3 is next week at MUSC, fingers crossed and praying since scans are not part of the SOC.

[joeguy in reply to PeteLG]

Yes, fingers crossed for you. I think they plan to scan me sometime after the 3 rd injection. I’m not sure how else they can tell if it’s working if PSA doesn’t mean much with Pluvicto

[Yank66]

DH had a decrease in PSA with each treatment. It was very encouraging to us, but nuclear med dr didn’t seem to read as much into it as we did.

[joeguy in reply to Yank66]

So PSA values during Pluvicto don’t really mean much?

[Yank66]

PSA is only one measure -scans tell the real story. That said, every drop made is feel more positive.

[LongTimeRunning]

My PSA dropped after the 1st infusion. PSA was already dropping fast because of ADT, but at least LU77 didn't cause it to rise.

[CAMPSOUPS]

I had a spike after my first Pluvicto infusion. I knew of the possiblility and the MO also assured have seen rise before reduction or stability. However you do have to keep your fingers crossed as not everyone reacts the same.

Mine so far (just got my 3rd infusion 2 days ago.

8/21/2023--PSA 343

8/29/2023--Pluvicto

9/13/2023--PSA 840

10/3/2023--PSA 702

10/11/2023 Pluvicto

11/08/2023--PSA 519

11/22/2023 Pluvicto

Goin in the right direction anyway. Hope yours does too.

[joeguy in reply to CAMPSOUPS]

Glad you’re heading in the right direction now. 500 points is quite a spike, did they offer any possible reasons? Seems I heard something about dying cancer cells giving off lots of PSA or some such thing.

[CAMPSOUPS in reply to joeguy]

Thanks. Yea spikes occur sometimes with initial chemo infusions. I would think the same could occur with Pluvicto sometimes.