is it just me? Lu-177 seems not to be as affective as once touted, seems hyper progression occurs.

[Shorehousejam]

is it just me? Lu-177 seems not to be as affective as once touted, seems hyper progression occurs.

[mperloe]

No, I think too many wrote about it as a miracle cure. It never appeared to work for a majority. Many had dramatic results but it is control not cure.

[cesanon in reply to mperloe]

That's interesting. How then did it get so far as it did without someone noticing this early on and mentioning even casually.

I'm going to be very disappointed if I now find this to be so.

There were a number of different carriers. Most certainly different ones had different results.

Does TAs website carry any numbers on how effective it is?

[Shorehousejam in reply to cesanon]

not that I see

[mperloe in reply to cesanon]

It's been reported that less than 50% respond but this is after most everything has failed. But it offers benefit for a fairly limited period before it fails. That info has been out there. Dr. Facebook showed a much greater excitement than the clinical research supported.

[Miccoman in reply to cesanon]

The flyer on Pluvicto my RO gave me and the Pluvicto website (not the patient but the HCP site -- toggle in upper left of screen) both mention a 30% efficacy. This was also stressed by my RO when we met to discuss the treatment.

I guess it depends on the provider's disclosure policy and due diligence by the patient to know that if you're in the lucky 30% (like me) things can go very well, if not you find out fairly quickly and have to move on to another treatment (or, in my case, hospice).

It certainly has been touted as a miracle cure -- and it is for the lucky 30% -- and there is big pressure to introduce it earlier in treatment, so there are other options if it doesn't work. BTW, a quick search now shows a 50.7% success rate when measured as any decrease in PSA. Oh, and now there's a big warning on their web site about how exposure to radioactivity can increase chances of cancer! LOL

Docetaxel didn't work for me, too toxic, and no one told me what to expect. I had to research it and recognize the SEs as they quickly piled up so I could report them to my MO and get it stopped. And Docetaxel is mainline SOC that everyone gets.

[Shorehousejam in reply to Miccoman]

Keep going, I’m in a bad way as last post describes

[Bacana in reply to Miccoman]

What were the side effects you experienced with docetaxel?

[rsgdmd]

I recall hearing someone one on a PCRI conference from 2023 mention that 1/3 do well, 1/3 do OK and 1/3 progress. Seems like few have durable results.

[maley2711 in reply to rsgdmd]

And "doing well" is generally buying a man a few extra months, not years, per my recall?

[EdBar]

Dr. Sartor explained it to as follows - 1/3 get a great response, 1/3 get a mediocre response and 1/3 get no response. This has been echoed by other top docs. In the world of cancer treatment, 1/3 getting a great response is pretty solid. And they are still working on other agent using PSMA as a target to direct treatment.

Ed

[treedown in reply to EdBar]

Seems like there should be a fourth percentage. Those who are worse off, a hit to their blood marrow or some other bad reaction. On this forum I have seen the really good reaction Patrick Turner and the hit Great John. However, as you said most get it after trying everything else so by then our bodies are ravaged and we need to keep expectations low IMO.

[EdBar in reply to treedown]

I know someone in my local prostate cancer support group who responded great, so it’s worth a shot, by the time you’re eligible for Lutetium there aren’t too many options left.

Ed

[cujoe]

Shorehouse - The following passage from the 2023 update to Patrick Walsh's Guide to Surviving Prostate Cancer may be helpful. (This most recent revision was a major one and provides a lot of updates on newer/evolving treatment options - recommended reading for all! Dr. Michael Carducci of Johns Hopkins provided "expert opinion" to this chapter of the major update to the earlier editions of the book.):

***************************

Pluvicto was approved with great excitement. Because everyone who receives the agent has tumor sites that express the target, we thought it should work in everyone. Yet that is not the case. Some patients get a long, durable response and have reduced pain; others have shown an early response—PSA plummets and pain gets better—but somehow, the cancer managed to work around it. Surprisingly, almost 30 percent of men who undergo treatment with Pluvicto have no response to it at all. It may be, in these men, that cells that don’t make PSMA are driving the growth of cancer. And here comes the same question we’ve been asking throughout this chapter: Could Pluvicto be more effective if given earlier? Maybe so! Pluvicto is being evaluated earlier in the course of the disease, in men with metastatic hormone-sensitive prostate cancer or in conjunction with first-line oral antiandrogens. Carducci says, “The hope is that Pluvicto will combine well with other treatment approaches, but so far, it’s too early to say.”

******************************

As yet, we are still waiting for a true (and universal) PCa silver bullet.

While we wait, Stay S&W,

Ciao - cujoe

PS I forgot about this critique by Vinay Prasad, MD MPH, of the Vision Trial that got Pluvitco approved :

youtube.com/watch?v=pAsPzPt...(Not working as expected?)

[Shorehousejam in reply to cujoe]

Thank you

[Xavier10]

Yeah I think the reluctance to try it early has shortchanged it's success. You have to be very advanced for most places to let you try it, which defeats the purpose sometimes.