Be careful: Pluvicto controversy, dammit!

[Maxone73]

not saying that it does not work, in fact for some patients it is simply fantastic, but still...they have damaged their reputation with patients

nature.com/articles/s44276-...

The PSMAfore and VISION trials for Lutetium-177 PSMA-617 in prostate cancer exhibit design flaws that bias outcomes toward the experimental arm. Issues include reliance on surrogate endpoints like rPFS, suboptimal control treatments that do not reflect current standards, inappropriate cross-over from control to experimental treatment, and high rates of informative censoring. These flaws can mislead regulatory approvals and result in unproven, costly treatments being adopted, misaligning clinical trials with genuine patient benefits and potentially leading to significant, unwarranted healthcare spending.

[TC007]

I am part of Pluvicto FB group and the results there is discouraging to me personally. I see its working for very few there and for majority making things worse with rapid progression. That's what u gathered from that group of 1k+ members.

[Cape1 in reply to TC007]

I’m also in those FB chat rooms and there seems to be a flurry of recent posts by widows, basically saying “ he was doing ok, then took Pluvicto and had a horrible death a month or two later”

[TC007 in reply to Cape1]

I have seen that and its quite scary. There was some kind of panic there until few weeks back. Now its better but doesn't mean results are better too

[JohnInTheMiddle]

What a surprise. And yet on every Zoom forum and so often on online forums, blah blah blah ever fancier and expensive treatments, and they give you how many more months? And then, oh sorry, too bad it didn't work for you. It is heart-rending.

And the big picture, maybe we are just guinea pigs for science. And therapies keep getting better and better.

But somehow I get a sense there's a difference between whiz-bang therapies with a lot of hype and therapies that are somehow more sensible.

Maybe someone can suggest how to distinguish between them. It's not clear to me we are dealing with honest brokers here all the time. But hey, I'm alive!

[swwags]

I was frankly astounded that the FDA approved this treatment for anyone other than compassionate care/ end of life. 38% success rate is abysmal.

[Tony666 in reply to swwags]

not sure I agree with your logic. If you are one of the 38% then it’s a godsend. And if you aren’t, well it’s unlikely to make things worse. So while I wish the success rate was higher, it’s still worth a shot.

[swwags in reply to Tony666]

Disagree respectfully as out of the 100% who receive treatment, 35% or so will have an adverse or negative response. So if I'm at end of like, weeks to live, then maybe...

[JohnInTheMiddle in reply to Tony666]

As per the initiating post, it seems the endpoints where arbitrarily defined. It's not 38% success in terms of living five more years. It's 38% success in some odd endpoint. And you probably live a couple of more months. And it seems pretty the original post that the studies themselves were based on dodgy methodologies.

[TC007 in reply to Tony666]

i dont think even for those 38% its "godsend". Even with those patients the response is marginally better than Chemo. rest much worse than Chemo so overall its a flop show

[Maxone73 in reply to swwags]

fact is that for those who respond, the response is usually great (not as great as with Cu-64, but still)....if you look at the only approved prostate cancer vaccine (sipulecel-t) the success ratio is even less, even if I suppose that response lasts longer

[TC007 in reply to Maxone73]

its not about success as such but what I understood is Pluvicto results in Rapid progression in some patients. Its necessary for manufacturer to identify who can benefit from this. I am sure they have this data and if just because of profit they are not releasing it then its a crime

[Maxone73]

But I feel like the concerns were more money oriented rather than efficacy oriented

[Hidden]

"high rates of informative censoring", Unfortunately censorship has become a very big part of what the medical "experts" do, as well as in everyday life by the "non-experts". I had questioned this treatment, and it's adverse in a reply to another members post. I was ridiculed and called a "conspiracy nut" by one of the most "Respected" members of this forum. I think SMART folks are waking up to the manipulation by the higher-ups and the oligarchy echelon they work for. Only my 2 cents

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

Hey Thomas,

I hate to be the bearer of bad news but your wife posted in your defense, that you are not a "conspiracy nut" but just a plain "nut".....(good idea to skip buying that diamond necklace you promised her).

Good Luck, Good Health and Good Humor.

j-o-h-n

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

I'll accept that!

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

hahahahahaha Thanks I needed that....

Good Luck, Good Health and Good Humor.

j-o-h-n

[lgutman]

This report and the more I read about Pluvicto scares me for my dad. My bio has the details but in the coming weeks we will need to decide what to do. Chemo and Pluvicto seem to be the only next steps. But my dad is very frail and is a huge fall risk in fact has had five falls since June 10. Despite his frailness he is having the time of his life in assisted living and QOL has been good. My gut says to stay on Zytiga and have it block some of the cancer versus doing other treatments. Any positive comments about Pluvicto?

[Maxone73 in reply to lgutman]

I truly have no direct experience, no clinical trial option maybe?