Pluvicto+Xtandi Delays Progression Better than Xtandi-alone in mCRPC

[Tall_Allen]

Significant improvement in progression-free survival, PSA, and pain scores. Side effects were fatigue, nausea and dry mouth.

prostatecancer.news/2024/04...

[FISHLAND]

Grand merci pour ça Anne-Marie

[caltexman]

I always look first for Tall_Allen's comments when I login to health Unlocked.

[Kayakbob]

I had quite a time getting my MedOnc to prescribe Xtandi prior to my Pluvicto treatment last year (Jan thru Sept) - claimed it was an 'experimental' application to get a synergistic response. I then provided info from Xtandi site showing that Xtandi was approved for mCRPC and mCSPC - it was prescribed based on this. I should be able to report back on this efficacy in the future.

[dhccpa in reply to Kayakbob]

Educating the doctor?

[OldWarrior]

My MO also took a little convincing. Showed him ENZA P interim results that showed Xtandi upregulates PMSA and makes Pluvicto more effective. Quick consult with RO and off we went. Two rounds of Pluvicto and a 50% drop in PSA. Third round delayed due to low platelets. Slowly coming back up.

[dhccpa in reply to OldWarrior]

What do these docs say once you've educated them? A scary phenomenon.

[OldWarrior in reply to dhccpa]

My MO is very open to patient input. I learned a lot about how to be my own advocate from TA and other old hands here. Understand what constitutes evidence. Ask specific questions. Send questions and evidence in advance. Take notes. Use medical terms if you can and use them correctly. My MO is at a teaching hospital - so he teaches, researches, is periodically the attending on the oncology ward at the hospital and sees patients. He has a family. I can’t imagine he has a lot of time left for reading studies and journals. I on the other hand have as much time as I want to research my disease.

[dhccpa in reply to OldWarrior]

Yes, I understand the dilemma.

[Tall_Allen in reply to OldWarrior]

Great advice!

[dmt1121]

Is there a clinical trial planned for the US? Is this a treatment that requires FDA approval before MO's will consider prescribing it?

[Tall_Allen in reply to dmt1121]

Both are approved by the FDA, so the combo is possible off-label in the US. Getting insurance/Medicare to cover it before docetaxel is another thing. If you've had docetaxel for mHSPC, it shouldn't be a problem.

[dmt1121 in reply to Tall_Allen]

Thank you.

[103532]

That is great news, and, as I always keep an eye to the future, I do worry about eventual MCRP. The 13 month progression free and 16 month radiographically progression free means there is more time and more hope. Thanks Tall_Allen!

[j-o-h-n]

And as the kid, they told you that you wouldn't amount to anything....................... So you showed them and amounted to everything..............You're an Ace in my deck..........

Good Luck, Good Health and Good Humor.

j-o-h-n

[Kayakbob]

Reading this trial info again - it shows that Pluvicto and enza is more effective than enza alone. It does not show Pluvicto and enza was measured against Pluvicto alone (which I'd like to see!)