My MO--whom I trust--has recommended Pluvicto as my "next best step", after 6 cycles of docetaxel didn't knock down my cancer growth. I was OK with her rec until today, when I had the consult with the nuclear medicine doc. He says they strictly follow the procedure in the VISION study and he hasn't had one patient yet who has lasted the full 6 cycles. Instead of the 30-40% success rate in the VISION study, they are seeing only 10-13%. He says, among other things, that the salivary gland damage is very common, and may be permanent. And because I have metastases in my lungs he's worried about the treatment causing pulmonary fibrosis. He still thinks I'm a good candidate (?) but was very direct about possible SEs. He wants me to have a pulmonary function test before proceeding. Now I'm scared. This doesn't sound good at all. Should I proceed? Would chemo [probably cabazitaxel] be as bad? My MO thinks it would be worse....
To Pluvicto or Not--That is the ? - Advanced Prostate...
To Pluvicto or Not--That is the ?
Hello,
Everyone is different. My experience with Lutetium-177 may not be yours but I sailed through four infusions with no side effects. No dry mouth, no nausea, no illness, no throwing up, nothing. The only side effect was fatigue. You also have to ask yourself what other options do I have? If I were you (which of course I am not) I would follow the advice of your medical oncologist. Good luck!
Thanks for your encouragement. That's just what I needed!
I also have finished 4 th tx with 2 to go.
No side effects but some fatigue. Psa dropping from 25 to 4.
I had a similar experience. No significant side-effects, and excellent PSA response.
I was in the same position as you, with minimal impact from my chemo treatment. I did 6 Pluvicto treatments, finished in December 2023. No discernible side effects. My post-treatment scans, both PSMA PET and Choline, show complete remission for which I’m so grateful. I will alternate PSMA and Choline scans every three months to monitor recurrence. I would say it’s worth the risk, but that’s just me, a non-expert. Make sure they give you scans along the way to see what progress, if any, you are making, and you can always decide to stop if it’s not working.
So glad to hear! Thanks.
I completed six cycles of Pluvicto in Feb 24; PSA now .2 and feeling OK.
Some dry mouth and lower blood counts; but good diet and some exercise will be helpful.
You know that everyone responds differently to any treatments;
Pluvicto has worked great for me , but I'm sure PSA will start to rise again.
Best to you
we tried it. My husband was an excellent candidate, good bloodwork and some bone Mets. Other than the isolation period, there were no side effects and he felt great. We did 4 rounds but his alkaline phosphate (and PSA) rose to over 230. A scan was done which showed major progression of bone Mets, skull to femurs. He was started on Jevtana chemo and will do for at least a year. PSA is 32 now although he’s been off since 8/30 due to hospitalization for radiation cystitis. We are 8 years in, started with surgery & radiation in early 2017
Was there an FDG scan done to correlate psma ?
It was a FDG scan
You know you have read on this forum how doctors sometimes give incomplete information or data on treatments. This group says “We should have been told”.
In your case you received the facts at least from the experience of that doctor. He gave you his experience with this treatment and it is now up to you to weigh results of the study versus physician experience.
Since I have not read the study perhaps that might help you decide. Every treatment has pros and cons. I guess it comes down to what you are willing to accept.
Not an easy call on your part but you are now informed. That doctor did his due diligence. Many others would not been so forthright.
I’ve encountered some who had a great experience with Pluvicto and others who felt it almost killed them. So much variability. Too bad they don’t have profiling tests to administer ahead of time to predict response.
So many valuable responses from you all! I feel much better about the whole situation now.
If and we all know our treatments are an "if" until we get the treatment and see our responses. But if Pluvicto goes smoothly for you I have to say it did for me and the side effects were absolutely minimal especially compared to chemo. I don't have any or little anyway saliva production but I feel its a small price to pay for some more time on earth. Its looking like my saliva glands arent going to get back to working condition on there own which they sometimes do so maybe I will have the procedure aimed at helping to open up the glands/passages so to speak
The physician who informed you of his opinion on Pluvicto seemed as though he was talking to a healthy person contemplating some type of medical intervention to improve life and here are the possible side effects for the next (20 years) . I don't know about you but unfortunately I don't stress too much over possible long term side effects as I'm not really a healthy person right now with stage 4 cancer and not looking to live another 20 years. I'm looking for more life and have to take it as it comes. You do unfortunately have stage 4 cancer. Your Oncologist is there to keep you alive longer and with the least harm done to you. I would follow him IMHO. Or her.
Thats a great perspective to look at things.
So ex respiratory therapist here replying about the question on the pulmonary function test. If you've never had one, they are a piece of cake and it's probably a very good idea to have a baseline.
I’m having a good response to Pluvicto. After 4 rounds, my PSA went undetectable, so I took a 5 month break. My latest blood work showed PSA increased to 0.3, so will probably continue with round 5 (if PSMA PET scan shows cancer is progressing). Most of my cancer is in my pelvic lymph nodes (minimal bone Mets). SE’s included nausea and loss of appetite. This is my experience, everyone is different. Good luck to you.
I had 10 docetaxal infusions that decreased my PSA by about 50%. However, my side-effects were severe, sleeping almost one week of every three, no energy, hair loss, lack of appetite. My experiences with Pluvicto have been very positive with good treatment response and almost no side-effects.
Debulk or not debulk, that is the question...
To neuter, or not to neuter? That is the question. 😀
Stopping docetaxel at just 4 per Dr - good move or not?
Radiate just the prostate when there is extensive lymph node involvement?
Is Pluvicto worth pursuing?
