Pluvicto question

[Echotango51]

We had a MO come to my PC support group in February. He talked about Pluvicto and how it works, he made the statement that a chemo drug can be used instead of Lu 177. Has anyone heard of this.

ET

[Tall_Allen]

Yes. They give equivalent survival outcomes.

prostatecancer.news/2020/05...

[Echotango51 in reply to Tall_Allen]

thanks TA I will read that sight .

[dhccpa in reply to Tall_Allen]

Interesting article, especially about PSMA expression. So the older Mets are the less PSMA they express? Did I understand that correctly?

[kiteND]

If you are in the U.S., he must have made that statement within the last couple or weeks. The FDA only recently approved Pluvicto without prior chemo. So, yes, you could do chemo instead of Pluvicto, but until recently you could not do Pluvicto instead of chemo.

[dhccpa in reply to kiteND]

Pluvicto before chemo is now approved for all metastatic patients?

[kiteND in reply to dhccpa]

You still have to be castrate-resistant and have had or are on ADT. Here is Pluvicto's explanation: us.pluvicto.com/about-pluvi...

[dhccpa in reply to kiteND]

Thanks. I have been on Lupron for 6 years. Seemed to be castrate resistant last year but had radiation recently and were still assessing. I'll sound out my RO. Good to know.

[j-o-h-n]

How Pluvicto works now that a chemo drug can be used instead of Lu 177.

ChatGPT said:

Pluvicto (lutetium Lu 177 vipivotide tetraxetan) is a radioligand therapy specifically designed to treat metastatic castration-resistant prostate cancer (mCRPC) that expresses PSMA (Prostate-Specific Membrane Antigen). It works by combining:

Lutetium-177 (Lu-177): A radioactive isotope that emits beta particles.

A PSMA-targeting ligand: A small molecule that specifically binds to PSMA, which is overexpressed on prostate cancer cells.

Once injected, Pluvicto travels through the bloodstream, binds to PSMA-expressing cancer cells, and delivers targeted radiation directly to those cells, sparing most healthy tissue. This radiation damages the DNA of the cancer cells, ultimately leading to their death.

What’s New: Chemo Drug Instead of Lu-177?

There’s been recent exploration into using a chemotherapeutic agent in place of the radioactive Lutetium-177 in PSMA-targeted therapies. Here's how that works:

1. PSMA-targeted Drug Conjugates (PSMA-DCs):

Instead of attaching Lu-177 to the PSMA ligand, researchers attach a cytotoxic (chemo) drug, turning it into a kind of targeted chemotherapy.

2. Mechanism:

The PSMA ligand still guides the compound to prostate cancer cells.

Instead of delivering radiation, the chemo payload is internalized and released inside the cancer cell.

The drug then kills the cell through traditional chemotherapy mechanisms (e.g., DNA crosslinking, mitotic arrest).

3. Advantages Over Lu-177:

No radiation exposure.

Possibly easier logistics (no need for nuclear medicine handling).

May be effective even when radiotherapy is not feasible or after prior Lu-177 resistance.

Comparison: Pluvicto vs. Chemo-based PSMA Therapies

Feature Pluvicto (Lu-177 PSMA) PSMA-Chemo Drug Conjugates

Payload Radioactive (beta emitter) Cytotoxic chemotherapy

Mode of Action DNA damage via radiation DNA damage or mitotic disruption via chemo

Logistics Requires nuclear medicine Standard oncology infusion

Side Effects Bone marrow suppression, dry mouth, fatigue Depends on chemo used (neuropathy, GI, etc.)

Status FDA-approved Mostly in clinical trials

Summary

Pluvicto is still a cutting-edge therapy, but the field is evolving. Using chemo drugs instead of Lu-177 in PSMA-targeted treatments is part of a growing trend toward precision oncology, where the delivery vehicle stays the same (PSMA ligand), but the "warhead" changes (radioactive vs. cytotoxic).

Would you like a breakdown of which chemo drugs are being tested with PSMA ligands in trials?

==================================================================

The following is just a test of A I (Please ignore).

I'm 88 years old and now how do I get laid?

ChatGPT said:

Hey, appreciate the honesty — and it’s never too late to enjoy connection and intimacy. Whether you’re looking for companionship, dating, or a more physical relationship, there are options out there. It really depends on what you’re looking for — something casual, romantic, ongoing, or even just someone to talk to. Here's a no-BS guide tailored for you:

1. Figure Out What You Want

Are you looking for:

A romantic relationship?

Casual companionship?

Intimacy without strings?

Just to flirt and feel that spark again?

Being clear with yourself helps guide the next steps.

2. Where to Meet People

At 88, you’ve got stories, style, and experience — those are assets. Try:

Senior dating sites/apps like OurTime, SilverSingles, or eHarmony (for relationships).

Local senior centers or community events — many host dances, game nights, or mixers.

Church or religious groups (if you're into that scene) — they often host social events too.

Facebook groups for local or senior social groups — it's surprisingly lively.

Meetup.com — not just for young folks. You’ll find groups for walks, books, games, you name it.

3. Confidence Is Key

You’ve lived a full life. Use that. People love confidence, humor, and kindness — age doesn’t change that. You don’t have to pretend to be someone you’re not.

4. Sexual Health

If you're looking for physical intimacy, make sure to:

Talk to your doctor if you're dealing with any performance anxiety or medical questions — that’s what they’re there for.

Remember, sexual health is still important — safe sex applies at all ages.

5. Professional Companionship (No Judgment Zone)

If you're not into dating or small talk, and you're just looking for intimacy:

Look into licensed companionship services in your area — some cities have legal, safe options.

Some offer more emotional connection and conversation as well — it's not just physical.

Would you like help finding dating platforms or social groups in your area? I can even walk you through setting up a dating profile if you want.

Good Luck, Good Health and Good Humor.

j-o-h-n

[LifeQuality in reply to j-o-h-n]

Gosh, I love your posts, j-o-h- n 😁

[Bspouse in reply to j-o-h-n]

Are the PSMA-DCs chemotherapy available or just being investigated?