Lutetium Lu 177 Vipivotide Tetraxetan

[Parscore]

So, I will have my first treatment with this Pluvicto treatment end of next month. I wish to minimize the expected side effects, if anyone has any firsthand experience to help minimize, and your personal experience with the results, it would be appreciated.

[Tasmanian]

I had my first Lu177 in early December. My only side effects were some bladder irritation that settled in about two weeks and some agitation from the dexamethasone given to prevent a pain flare.

[Mbnm in reply to Tasmanian]

is Lu 177. pluvicto ?

I am on abiraterone and lupron injection for about 5 months

Psa and testosterone under control so far

By big issue is cancer in several lymph nodes

The Lutetion injection seems ideal for me but CO says wait

How is your situation different from mine ?

[spencoid2 in reply to Mbnm]

I asked my nuc med doctor why Lu 177 is not used earlier when it might be a cure before the small mets could get going. it was explained that a certain level of radiation is necessary to kill or debilitate the cancer cells and that the amount of isotope that is attracted to a single cell or a small group of cells may not be enough to be a lethal dose, it requires more cells gathering the isotope to generate a strong enough field. sort of made sense to me. but if they could increase the intensity of the radiation and limit how far it goes it would seem that it might be possible to get a strong enough dose from fewer cells.

there is another isotope that is being used maybe just in trials. it is actinium. as i interpret the articles, LU 177 is a gamma emitter which has greater effective distance but less energy so is not as good as actinium which is an alpha emitter which has less reach but more energy so it effects surrounding areas less?

if i have the backwards please correct me. I did hear the opposite at first or remembered it backwards the first time.

[Tasmanian in reply to Mbnm]

I am on ADT only atm and have extensive bony mets. I was also on the combo of opalarib (I have the relevant mutation) and darolutemide (compassionate access due to drug interaction) did nothing more than make me feel awful. My oncologist stopped these two and said its either chemo or lutetium next (and thats the end of the road for me unless something new appears).

Further, oncologist and nuclear med physician administering the lutetium spoke of growing evidence that it is useful earlier than it had been used in trials.

[Izzygirl1]

My husband had his first Pluvicto treatment on Tuesday. He’s been tired and has felt nauseous. Been taking his Zofran for nausea every 12 hrs to get ahead of it and that seems to be working. He also takes Dilaudid every 6 hrs for pain relief which he had before Pluvicto. I told him today to take a gummy to help with his emotional state… very weepy. We haven’t been able to snuggle this week because of his level of radiation from the Pluvicto. 😞

[Tasmanian in reply to Izzygirl1]

The distancing part of the treatment isn't fun at all, I agree. Hoping things settle for him soon. Wishing you both all the best.

[Izzygirl1 in reply to Tasmanian]

Thank you!! 🩷

[Miccoman]

I get my 4th injection next week. I have extensive bone mets and was prescribed steroids to prevent rebound pain.

I had a little loose bowels the first time and dry mouth, of course. I do suck on ice chips the entire time I'm there to keep my saliva glands at minimum output on the theory that that will help keep the Pluvicto from landing there too much (saliva glands also present PSMA so Pluvicto attacks them as well as tumors).

So far just the dry mouth. The rest seems to be handled well by the steroids (one week of diminishing amount). Stupid that they aren't part of the protocol! But that has to do with QOL, which isn't of much concern, in my experience, to doctors -- I had to get a second opinion at MSK to get the local RO to prescribe them.

Good luck and I hope you have as good results as I: Start PSA 99.8, current PSA 26.5.

Oh, and don't be surprised if PSA rises after first dose -- mine went up to 106 three weeks after the first dose but started dropping fast by the fifth week.

[Parscore in reply to Miccoman]

I am sorry, I did not note that I will not be doing any Chemo with Lutetium Lu 177 Vipivotide Tetraxetan. Anyone receiving this treatment without chemo?

[Miccoman in reply to Parscore]

There seems to be some miscommunication here. I am not on chemo. I'm not even on Lupron, so Pluvicto is the only cancer treatment I am taking.

The steroid is to combat any rebound pain from the Pluvicto caused by the extensive bone metastases and it was recommended by a MO at MSK.

Oh, and there can be some mild nausea but they have started me on Ondansetron, which has taken care of that (no one is sure if the nausea is from the Pluvicto or from an earlier radiation treatment that went wrong -- in any case my tummy is all good now).