What’s after Lu-177 in Vancouver, BC?

[PHnerd]

Hi there, I’m located in Vancouver, BC 🇨🇦. My dad is on a clinical trial and after over a decade with this disease he has failed Zytiga, Xtandi, docetaxel, and is now on his 4/6 Lu-177 infusion. He’s castration-resistant and metastatic. PSA decreased considerably after the first Lu-177 infusion but sense then it’s been climbing slowly (~4.00 currently). What’s next? I’m his eldest daughter, 27, and I just can’t bear to see him in this position. I feel hopeless and devastated.

[Tall_Allen]

cabazitaxel, xofigo, combinations, clinical trials...

[GP24]

As your dad failed Zytiga, Xtandi and Docetaxel I would consider 4.0 a low PSA value. He should continue his Lu-177 therapy. After that he can get a break and then a chemo with Cabazitaxel.

[RyderLake2]

Hello,

Is your dad receiving Lutetium as part of the clinical trial he is on? If so, what is the name of the trial and is it being offered through the BC Cancer Agency?

[PHnerd in reply to RyderLake2]

Hello! Yes it’s part of a clinical trial. It’s through the Vancouver Cancer Research Centre near VGH. I’m not entirely sure of the name of the trial, but he was originally randomly assigned to docetaxel which didn’t get rid of all the cancer (and resulted in his left leg going completely numb) so they did a treatment crossover and are now trying the Lu-177.

[RyderLake2 in reply to PHnerd]

Hello,

The reason I asked, is that I too live in British Columbia. Like your Dad I am in a clinical trial (called SPLASH), investigating the use of Lutetium pre-chemotherapy. The reason for enrolling in this trial is I that have never taken chemotherapy and have always been interested in nuclear medicine. When I began this trial I was randomized to the non-Lutetium arm. In my case that meant switching from Xtandi to Zytiga, although with a rising PSA I think I am getting close to crossing over to Lutetium. I initially thought your dad and I might be in the same trial but what confused me is that your dad went through docetaxel or chemo before beginning the Lutetium. After reading skiing fiend's response to me, I now think your dad is in a fairly new BC Cancer Agency trial comparing Lutetium to chemotherapy. For all of us battling PCa, this is a very important comparison. Good luck to you and your Dad. Stay in touch if you wish!

[Mbnm in reply to RyderLake2]

I am in Vancouver after urologist late referral I was shocked to have advanced cancer --petscan showed several cancer lymph nodes--now on aberaterone, lupron and prednisone for last 3 months psa down from 12 to 0.008 and T at 0,2 with headache side effect

So I am very interested in lutetium --- does that mean I would only be eligible for lutetium when/if my current treatment fails ?

Thanks

[skiingfiend in reply to Mbnm]

Lutetium treatment is only available as clinical trial in Canada, or, private clinic. When you advance to Castration Resistance you may be accepted for clinical trial if one is running, it is recruiting and you meet eligibility criteria.

[Mbnm in reply to skiingfiend]

private clinic also says after chemo but we should expect that to change--they will also do one or 2 treatment rather than 6 and allow you to stop early if there are side effects

[RyderLake2 in reply to Mbnm]

Hello,

Lutetium has been approved by Health Canada but only after chemotherapy. Several clinical trials are investigating the use of Lutetium pre-chemotherapy and therefore much earlier in a patient's treatment plan. The bad news is just because Health Canada has approved a drug does not mean that individual provinces will make it eligible for funding through either your local Cancer Agency or provincial medical services plan. Remember individual provinces look after health. Skiingfiend is right. Your best option right now is to receive Lutetium is through a clinical trial. Hope that helps!

[PHnerd in reply to RyderLake2]

Hey RyderLake2, my dad was actually in the same boat as you because he never had chemotherapy before being randomized to the chemo arm, but I definitely think it’s the same trial. Dad’s trial is comparing chemo to Lu-177 and he exhausted Xtandi and Zytiga before joining the trial as well! I’ll try to get the name from him but he doesn’t like talking about his cancer so I’ll have to do some investigative digging on my own haha. I’m wishing you all the best and please don’t hesitate to message me with any questions, especially as we are in the same city!

[skiingfiend in reply to RyderLake2]

GUPR21. Yes. Registration is open, looking for 200 max.

Canada wide, phase 2 docetaxel vs lutetium in 1st line mCRPC.

clinicaltrials.gov/study/NC...

[tango65]

There is the epi-7386 trial of a new anti androgen (protac) which may be recruiting in Vancouver

clinicaltrials.gov/study/NC...

There are preliminary data and it may work.

[Maxone73]

Seattle?? clinicaltrials.gov/study/NC...

We have some guy here who has been in this arx517 trial and had good results

[PHnerd in reply to Maxone73]

Thank you so much! I really appreciate all of these options 🙏🏽

[j-o-h-n]

Would you please let us know your dear Dad's age. BTW He's very fortunate that he has a sweetheart of a daughter. Regards to all.

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 01/03/2024 7:47 PM EST

[PHnerd in reply to j-o-h-n]

Thank you John 💕 he’s 64.

[Maxone73]

Maybe too far from Vancouver, but I think they are testing it in Canada somewhere:

prnewswire.com/news-release...

[Maxone73]

globaltrialfinder.janssen.c...

this could also be interesting, in Seattle, not that far way