Decision time coming up

[Miccoman]

Hi everyone,

I'm having another PSMA PET scan tomorrow and then, next week, will be meeting with my current MO @ University of Rochester Medical Center and then my new MO at Roswell Park Cancer Center.

My URMC MO has offered "two additional cycles" of Pluvicto, upon Nuclear Med OK and not much else.

The RP MO offered a laundry list:

1. New genetic profile: liquid biopsy

2. AR rechallenge: Abiraterone (Zytega) 1 pill per day with food –5 or 6 months

3. Pluvicto rechallenge – at least one full round, depending on

1. Nuclear Medicine

2. Insurance (traditional Medicare so this will be OK)

4. Cabazitaxel? Start low dose due to bad reaction to Docitaxel

5. Studies:

1. Testerone challenge, requires

1. biopsy – bone or blood

2. high dose testosterone for once a month for 3 months

3. restart AR (Abiraterone is Dr Chatta’s preferred AR)

2. Bipolar Androgen Therapy (Dr Chatta is principle investigator)

1. has to be amended to accept people who had Pluvicto -- happening shortly

3. actinium → alpha radiation vs beta in Pluvicto

1. Cornell in NYC

2. Mayo in Rochester, MN

6. Phase One experimental drugs

So, with all the knowledge in this group I'd really appreciate any thoughts. My PSA is slowly rising, although it did have a bigger jump in Oct, it only went up one point in Nov. It's now at 10.8, up from a low of 5.26 last July.