Re "Why Lutetium-177-PSMA treatment sometimes may not help, and may even harm" article

[podsart]

In this article, the following is stated

• In men with low PSMA, the PSA50 was 52% for Lu177PSMA vs 32% for cabazitaxel

Why with a low PSMA would be higher [ PSA50 ] at 52% vs 32% for Jevtana?

[Tall_Allen]

Pluvicto had much greater PSA50 in men with high PSMA. There was no difference in survival, however.

• In men with high PSMA, the PSA50 was 91% for Lu177PSMA vs 47% for cabazitaxel

• Among men with high PSMA, the odds ratio of responding to Lu177PSMA was 12.2 vs 2.2 for cabazitaxel

• In men with low PSMA, the PSA50 was 52% for Lu177PSMA vs 32% for cabazitaxel

• In men with high FDG, the PSA50 was 57% for Lu177PSMA vs 20% for cabazitaxel

• Among men with a high FDG, the odds ratio of any response to either treatment was 0.44

• In men with low FDG, the PSA50 was 70% for Lu177PSMA vs 44% for cabazitaxel

[OuttaTime in reply to Tall_Allen]

I don’t understand how you have this worded psa50? What does greater psa50 mean greater than psa 50? Or the psa50 was 57% for Lu-177 vs 20% cabazitaxel? I don’t understand?

[podsart in reply to OuttaTime]

Not sure, but think it means the person had a drop in psa of 50 pct [or more] as result of treatment

[Tall_Allen in reply to OuttaTime]

It is out of context - I was replying to podsart's OP. He was asking a question about my article in which PSA50 is defined.

"They looked at the percent of men whose PSA reduced by 50% or more (PSA50)"

prostatecancer.news/2019/12...

[OuttaTime in reply to Tall_Allen]

Thank you!

[ulfhbg in reply to OuttaTime]

Hi !

I think PSA50 is the percentage of how many that had a PSA decline of 50% or more when treated.

So if for example 20 persons was in the category of high PSMA and 15 of them had a PSA decline of 50 % or more that would be 75 % was in the category PSA50 i would guess

[OuttaTime in reply to ulfhbg]

Thank you!

[Islandboy2021 in reply to Tall_Allen]

I have been able to get the PSMA scan here in Canada but I don’t think they have the option for a FDG scan. How is the FDG scan done. Should this scan be SOC when you are checking to see if you are PSMA positive before having Pluvicto.

[Tall_Allen in reply to Islandboy2021]

Anyone who offers any kind of PET scan offers an FDG PET.

[ulfhbg in reply to Islandboy2021]

When I had my 3 cycles of Lu177 in Finland I had to have a DCFPyL and also a NaF. There was not any discussions in my case to have a FDG, not saying that they don’t use it for some when needed

I had very high SUV Max in both prostate and my affected lymph nodes and that was the check that I was a good candidate for Lutetium treatment.

But like I said, in this case it was how the clinic in Finland I was treated in handled scans to make you were a candidate for Lutetium

On a side note, they also had a SPECT/CT Done 24 hours after each cycle to see radiation activity and any decrease, progress and etc. and they used the DCFPyL and NaF to compare with each SPECT/CT.

Like I said, just a side note on how the finish clinic Docrates is treating with Lutetium and perhaps others that treat with Lutetium uses FDG as well in order to see if you’re a good candidate for Lutetium