Lu177 + Enzalutamide + ADT

[John347]

Hi everyone, I have been invited to participate in a clinical trial to investigate the efficacy of Lutetium Lu177 for early stage patients. My PSA has been rising steadily the last few months from 0.02 ug/l and is currently 0.22 ug/l.

The trial will divide patients into 2 groups- Group A will be given Lu177, enzalutamide and Lupron. Group B will just be given Lu177 and Lupron. I am concerned about the combined SEs of the drugs.

I am interested to hear from those who have experienced these drugs simultaneously.

Thank you. God bless.

[RyderLake2]

Hello,

I have gone through the Lutetium process with very few side effects. Fatigue was probably the worst. Waves of drowsiness but then I am also nearly 80. I had been on Xtandi (enzalutamide) for five years prior to taking Lutetium but this was stopped before going on the Lutetium trial. My advice, for what it is worth, is go for it. The radiopharmaceutical approach is easier on you than chemotherapy. Good luck!😉

[TeleGuy]

Enzalutamide was a real brain fogger for me, but if you are assigned to that arm it will be worth it because it should intensify the PSMA expression. At your low PSA I wouldn’t expect anything other than fatigue from the Lu177. I also did it pre-chemo and had some fatigue for a week and a little nausea a few days after the infusion.

[Tall_Allen]

The ENZA-p trial tested that combination in men who were castration resistant:

prostatecancer.news/2024/04...

[Kayakbob]

Went thru a similar combo, lu, enza, and orgovyx for adt. Went well, se's from lu not bad, after treatment Went off all meds 14 months ago, psa still extremely low (0.096). Enza adds efficacy to the lutetium per published studies. I would recommend, but the cost for enza can be daunting.Best of luck!

[spencoid2]

I did not do the combo just pluvicto. Do want to warn about the possibility of persistent xerostomia. I have been hoping that it would subside but it hasn’t and it makes eating a chore. You might ask about ways to avoid this. Not a very high incidence supposedly but a real bitch if you get it. Other ligands target the saliva glands less than whatever they used with pluvicto. Whatever Lu you are getting might use a more selective ligand. Can’t hurt to ask.

[CRPCMan]

Seems like a lot for little numbers. My best to you.

[John347]

Thanks to all who responded .After doing much research on the side effects and toxicity of pluvicto or Lutetium Lu177 , I have decided not to proceed with the clinical trial especially since my PSA is so low at 0.22 ug/l. It's like killing a mosquito with a sledgehammer. I think Lu177 will definitely do me more harm than good.

[sandystarfish in reply to John347]

Was wondering if this trial is being conducted in Sg since we are based in kl.

[John347 in reply to sandystarfish]

Yes, it's in Sg.

Google the following:

177lu fap 2286 novartis

[garyjp9]

That seems like a good decision to me (not that you were asking!). I know that my MO would not recommend any treatment at that PSA level. But monitor the doubling time, as well as the level.