PSA rising with Pluvicto

[IkeLuke]

My husband started on Pluvicto. Before first injection PSA was 52, and after a month it is 58. What to expect after second injestion?

[Tall_Allen]

Did he have an FDG PET scan in addition to his PSMA PET scan?

[IkeLuke in reply to Tall_Allen]

No, but he had CT/PET earlier. He was in clinical trial since January to September on different medication when his participation was cancelled due to cancer growth back. It’s in lymph node in his abdomen, so our doc saw it many times.

[Tall_Allen in reply to IkeLuke]

He might want to get an FDG PET before continuing with Pluvicto.

[spencoid2 in reply to Tall_Allen]

What does an FDG PET show that is different? I am starting Pluvicto tomorrow and want to collect all the information I can about what to expect etc.

[Tall_Allen in reply to spencoid2]

prostatecancer.news/2019/12...

[spencoid2 in reply to Tall_Allen]

i did not have an FTG PET scan and am having pluvicto today. should i ask for an FTG PET scan to be done ASAP? can the FTG be done while Pluvicto is giving off radiation or does it have to be done before PLuvicto or after it loses its radioactivity?

[Tall_Allen in reply to spencoid2]

The point of an having both PET scans is to avoid unnecessary treatment in some men. There is no point in having it after treatment.

[spencoid2 in reply to Tall_Allen]

i asked and they said they are aware of the scan and that it was not necessary at this point. i have a series of various scans scheduled and the FTG would only be done when and if i do not respond to the pluvicto. i have very high (whatever it is called) of PSMA so they think that at least that PC will receive treatment.

[Tall_Allen in reply to spencoid2]

FDG, not FTG, btw

[spencoid2 in reply to Tall_Allen]

too many acronyms

[spencoid2 in reply to spencoid2]

BTW i am being treated at UCSF by Dr, Hope and my oncologist is Dr. Aggarwal so they probably have it under control as much as possible.

[Gumbo2023]

my husbands psa also rose with pluvicto but convinced dr to proceed with last 2 treatments in addition to radiation for 15 days on numerous lesions 1st pet scan showed a decrease of brightness in some lesions so that is why they continued treatments and zapped lesions that were still bright. Pet scan tomorrow. Results in 7 days. Will let you know when I receive them.

[robert570]

I began Pluvicto treatments on March 17, 2023. My PSA stood at 1.56 I had a lab draw on May 9th, my PSA rose to 2.31 On May 19th I began my 2nd Pluvicto treatment. Being concerned, I had a blood draw on June 6th and my PSA had risen to 3.6 They continued with the 3rd infusion on June 30th. I had another blood draw on July 3rd, and my PSA had risen to 4.9, August 1st 8.81, August 11th 10.18 The next infusion was to begin on August 17th, but I stopped it. It didn't work for me. My PSA for October was 19.94, November, 22.35, December fell back to 19.94 I started on Jevtana and Carboplatin in late August and have had 6 rounds so far. As stated before the combo has stopped the rapid rise and is fluctuating. I'm doing well with no side effects on the Jevtana. The carboplatin had to be dropped after the 5th round due do a burning sensation in my throat and tongue. I was only supposed to go with 6 rounds. So now I'm on Jevtana by itself with Prednisone. I was on Jevtana previously, but they stopped it to try Pluvicto, which in my case was a mistake. I heard that Pluvicto works for most men, but unfortunately that was not my case. I would go up to the 3rd round and see what happens with his PSA. When you get labs before the 4th, that should tell you something. His PSA might start dropping and I hope it does. Just keep an eye on things and good luck. It has been 10 years since I was diagnosed at age 52 with Prostate cancer. I have had various treatments. Most worked until those little cancer cells found a way around it. I could write a book. Need more info, just ask. I'm an open book.

[Benkaymel in reply to robert570]

You appear to making all your judgements on Pluvicto via PSA levels. Did you have any follow up PSMA PET scans to see what effect it had on the actual cancer?

[robert570 in reply to Benkaymel]

PSA is where it's at. Never went above 3 until I started Pluvicto. I go on gut feelings. Being back on Jevtana and it's starting to go lower. That's all I need to know.

[Benkaymel in reply to robert570]

The reason I said it is that my PSA dropped to <0.1 while I was on HT but scans showed my tumours were still progressing. PSA was totally misleading for me.

[robert570 in reply to Benkaymel]

That's what I mean everyone is different. In my case the PSA wasn't misleading me so far. That's why this disease doesn't have a cure yet, but I'm hopeful.

[FightNow in reply to robert570]

Are you able to give an update on how Jevtana and Carboplatin ended up working for you?

[chipspesto]

Just completed the 4th Pluvicto treatment, CT ,Bone Scan and blood work all indicated things are going well.

PSA before treatment was 63 , now below 4. I know this treatment is not for everyone and after Pluvicto I might have to begin Jevtana again.

Been fighting cancer for 17 years, QOL is Okay. Deep breathing exercises each day really help.

Best to you!

[Cateydid]

after the second dose my Joe’s PSA rose a wee bit. Now, after 4 doses, it’s down to 1.43 (from 12 when he started)

Dose 5 tomorrow. Dose 6 January 16. Sometime after that his doc will request follow-up PSMA scan. Has said there’s no reason to do FDG scan.

He also said, when I asked about B12 supplements to combat his anemia, that cancer patients tend to have anemia, and he doesn’t usually do anything about it. I’ve read some research that suggests B12 helps cancer patients with anemia, so I ordered some and will increase foods that help make healthy red blood cells.

I wish I knew what to expect next. When I asked onc, he said there are but a few men who have made it through 6 doses and beyond, so there’s not much data.

I guess we’ll see, won’t we?

[Miccoman]

I hope you were told not to expect positive results until after the 3rd injection.

For me, who seems to be among the 30% who respond well, my PSA was 99 before my first injection, then rose to 106 after 3 weeks and was down to 91.8 at 5 weeks (my RO wants labs at 3 weeks and the week before the next injection).

At 3 weeks after my 3rd injection my PSA is now 31.8.

Additionally Alk Phos, which shows problems in bones and/or liver, has come down from a peak in September of 268 to just over normal at 134. My MO is very pleased and I'm "cautiously optimistic" as they say.

[fmoser]

My dad’s nuclear med doc said it’s common that PSA can rise after the first infusion before it falls. Not sure how accurate that is. I do remember hearing that.

[IkeLuke in reply to fmoser]

Thanks a lot, it helps!