Failed Pluvicto- What’s Next?

[Jshaw916]

Guardant 360 test showed no mutations. Dad recently failed Pluvicto. What’s next after Pluvicto? Anyone have any success with treatment after failing Pluvicto? He talks to the oncologist 8/20 for next steps.

[MJCA]

Hi,

I have finished my fifth cycle of Pluvicto. A PSMA-PET after cycle 3 showed most tumors were dying or receding. My latest PSA indicated a 9 week doubling time. So, I am getting another PSMA-PET next Monday to see what’s occurring. My MO indicated the next treatment would be Jevtana/cabazitaxel and possibly Keytruda after.

[Jshaw916 in reply to MJCA]

thank you for the quick reply! I’m hoping my dad will go through chemo again.

[MJCA in reply to Jshaw916]

I’ll tell you that chemo is no cake walk! I wish your Dad all the best.

[RyderLake2]

Hello,

You might want to investigate an Alpha radiopharmaceutical like Actinium. There are several clinical trials underway. Good luck!

[Healthunlocked133 in reply to RyderLake2]

Stanford is also starting a CU 67 trial that I might qualify for. This is another alpha emitter and the ligand is new too

[Cenerus in reply to Healthunlocked133]

CU 67 isn’t an alpha emitter, it’s a Beta emitter. If it’s the new Clarity drug, it shows better performance than Pluvicto.

[gsun in reply to RyderLake2]

After getting Pluvicto, I don’t think actinium would be done.

[RyderLake2 in reply to gsun]

Hi Gregg,

That’s what I thought too. However, if you look at the Actinium Trillium clinical trial being offered at the BCCA it looks like for Cohort C they want people who have been previously treated with Lutetium. That’s the way I read it anyway. Also in Germany, Australia and much of the rest of the world (outside North America) it is not uncommon to follow Lutetium with Actinium.

[lgutman]

I am so sorry about your dad. I didn't see his age. My profile has dad's story as do my posts. Watching a parent battle cancer is terrible. I listened to a book called "Being Mortal" and I urge you to listen or read chapters 5-8 and/or find the author's videos on You Tube. My father's cancer has been very aggressive from the beginning and diagnosed at stage 4. We called in hospice when we hit a downward spiral and moved from performance status 2 to a 3. Best thing we did. They are helping us maintain a quality of life that is important to my dad. From one child to another you all are in my thoughts.

[dk73]

we stopped pluvicto after #4. ALP & PSA were over 230. Scans showed major progression of bone mets, skull to femurs. Now on cabaxitaxel- ordered a years worth. Has had 5, PSA now 59. Asked about 225 but they wanted to stop this spread and hubby did ok on taxotere the two times he did it before.

He is 71. Started with surgery/radiation in 2017. Chemo in 2017-2018. Zytega in 2020. Xtandi in 2021. Chemo in 2022. Pluvicto in 2023. Back to chemo 😬

[dmt1121]

Hopefully Tall Allen will reply, as he is very knowledgeable.

All I will can say is that there are still treatments available for you but they tend to be more aggressive and may have substantial side effects. Do your own research and come back to your MO with questions about treatment plan long-term benefits and side effects, as well as appropriateness for your stage and type of PCa.

The key for me is what stage I am in the progression of my disease, so I can select the best treatment plan that allows for more options later. For me, quality of life is so important too that the benefits of each treatment must balance out with the side effects and overall survival and progression of the disease. For instance, I am very resistant to undergoing chemo again, even though Cabazitaxel a different than Docetaxel.

I hope you find the path that is right for you. Good luck!

[FrostGyre]

Carnivore diet (not really a diet, but a lifestyle).

When years of being poisoned don't achieve the desired results, try the original human diet. 👍