Pluvicto and PSA

[MJCA]

Hi Gents,

Prior to starting Pluvicto my PSA was 29.29, after round 1, 23.67, after round 2, 14.47, after round 3, 17.70. I then had a PSMA-PET scan. It showed all bone metastases except one were either receding or gone. After round 4, my PSA is now 21.51.

I don’t get it. If almost all my metastases are improving, why is my PSA elevated? I posed this question to both my doc in Nuclear Medicine and to my MO. Given the holiday, I don’t expect to hear back until Monday.

If someone could illuminate me as to why this is happening, I would appreciate it. Of course, I am on Lupron.

Thanks! Belated Happy Canada Day to my fellow Canadians and happy 4th to my fellow Americans!🇨🇦🇺🇸🎆🎇

[Tall_Allen]

Dead tumors release PSA maybe.

[MJCA in reply to Tall_Allen]

Thanks Allen!! That makes me feel a bit better!! I appreciate it!

[spencoid2]

my response to Pluvicto was not as hoped. i just did a series of external radiation to keep me alive until a better treatment comes along. i am hoping for actinium with better more specific ligand.

my last radiation was about 3 weeks ago but i was told to not get a PSA test until at least a month and maybe two after the last radiation treatment. if successful the radiation kills cancer cells and they can release PSA in the process. cancer cells are not "killed" by the radiation, rather it induces fatal mutations that cause the damaged cell to die when it tries to reproduce. so it can be a while before the cancer cells die and release PSA. That is the reason to not rush a PSA test or expect it to immediately indicate successful treatment

[Drago101 in reply to spencoid2]

Same here, I did 38 sessions of Salvage Radiation in May. The PSA test will be in Aug as my DR had same reasoning as yours.

[Bronzee]

maybe resolved mets still release PSA.. i had same experience after SBRT and VMAT .. although , it is slowly going down.

[SViking in reply to Bronzee]

How long after SBRT treatment to take for PSA to go down?

[Z06505hp]

Hi, I appear to be in the same boat. My PSA was 14 when I received my first dose of Pluvicto. It dropped to 3.7 then and after my second dose it dropped to 1.3. It is now at 2.7. I am receiving my third dose today. I'll will keep you posted on today's results. No PSMA-PET scan yet.

[Aldo62]

Nubeqa (daroludamide) will also help to lower PSA, with very few side effects. It blocks the T receptors in the Cancer cell.

[MJCA in reply to Aldo62]

Thanks. I am way past 2nd generation ADT. Already tried Nubeqa 2 years ago. For me, bad S/E