PSA results from lu 177

[Rexwaterbury]

For those who have undergone lu177 treatment of mcrpc, either through the vision trial or abroad, can you please share your PSA results, both during the treatment and also after the treatment was completed.

Thanks in advance.

[cesanon]

Have you taken the treatment or are you thinking about it?

[Rexwaterbury in reply to cesanon]

Currently being treated in Heidelberg.

[cesanon in reply to Rexwaterbury]

What do you think so far?

[Rexwaterbury in reply to cesanon]

Too early to tell for me. Would like others to share their results.

[Tall_Allen]

Did you make it back for a second treatment?

[Rexwaterbury in reply to Tall_Allen]

Yes, on March 17. My next treatment is next week on May 7.

My concern is my PSA which went from 85 to 55 after my first treatment (which was good.) My PSA has gone back up to 84 after my second treatment, which I’m hoping is due to more tumor kill and PSA release, but fear it might be something else.

[Tall_Allen in reply to Rexwaterbury]

I forgot, did you have an FDG PET too?

[Rexwaterbury in reply to Tall_Allen]

No FDG pet, but ALL my lesions on ct scan were intensely Psma avid.

[Tall_Allen in reply to Rexwaterbury]

Great! Hopefully any intra-tumor heterogeneity gets killed in the cross-fire.

If you see Haberkorn, ask him if he's started treating patients with Lu-177-FAPI.

[Rexwaterbury in reply to Tall_Allen]

Nobody gets to see Dr Haberkorn. Only get to see his protégés.

Do you think I need to be worried about the PSA increases since the last treatment, or too early to tell? I had a 45% decrease after my first treatment, so I was hoping for something similar, but not to be.

[Tall_Allen in reply to Rexwaterbury]

You may be right that PSA is still elevated because the cell kill was so good. Usually the largest PSA decline is after the first treatment, and what's left is less PSMA avid. As you know, I think getting an FDG PET too is prudent.

[cesanon in reply to Tall_Allen]

Tall_Allen

I looked up Lu-177-FAPI on your blog at:

pcnrv.blogspot.com/2019/12/...

It looks interesting. It appears to be the ligand.

One issue I have with PMSA Ligand is that that it is attracted to and/or processed by your kidneys and salivary glands. It can damage them.

Does FAPI have any such drawbacks?

Any other pros and cons for FAPI?

Is there anything that PMSA ligands are likely to do better than FAPI ligands?

[Tall_Allen in reply to cesanon]

Those are different issues - toxicity and effectiveness.

[cesces in reply to Tall_Allen]

I meant to include both the issues of toxicity and effectiveness.

Is there any reason to believe 177 FAPI is less effective than 177 pmsa?

[Tall_Allen in reply to cesces]

That article is everything I know about it

[Teddysdad]

I ave recently had my 5th Lu177 treatment and overall my PSA has gone from 1,584 down to 167 most recently (although I had a blood test yesterday and am awaiting the results). The biggest changes were after treatments 1 and 2 with the PSA roughly being halved each time, things have slowed a little bit now.

The other important factor with the treatment are the PET Scans, my most recent one after treatment 4 showed that all tumours had reduced in size by 50%.

There is talk about having additional treatments so maybe up to 8, with 7 and 8 being spaced further apart.

I suppose for me the worry is that as soon as treatment stops then the cancer will bounce back.

I am having treatment privately in London.

Hope this helps?

[mklc]

Best wishes for a fantastic outcome after the Lu 177. warm wishes

[Rexwaterbury]

Today I heard from one of the doctors in Heidelberg. They are going to increase the amount of Ac and decrease the amount of Lu for my treatment next week.

[Tall_Allen in reply to Rexwaterbury]

Do they do the sialendoscopy procedure there if your salivary glands dry up?

[Rexwaterbury]

I am unaware of that. I have not had significant dry mouth, only while sleeping. Eating has not been an issue.