FDA Approves another PSMA PET scan fo... - Prostate Cancer N...

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FDA Approves another PSMA PET scan for Prostate Cancer Imaging

Tall_Allen profile image
19 Replies

This is another Ga-68-PSMA-11 PET scan called "Illucix" that will be available from 140 nuclear pharmacies in the US, vastly expanding the network.

onclive.com/view/fda-approv...

Like the other two PSMA PET scans, it is approved for both recurrent patients and high risk patients (to rule out distant metastases).

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Tall_Allen profile image
Tall_Allen
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19 Replies

Thanks, TA for posting. The more, the better for us patients.

GDeG profile image
GDeG

Thanks for keeping us up to date!

mperloe profile image
mperloe

This suggests that those with GL 7 or PSA over 10 were considered prior to moving forward with definitive treatment. With the advent of new focal or local treatments the ability to more precisely evaluate patients prior to treatment should improve the success associated with Tulsa Pro, HIFU or FLA by identifying the extent of disease more precisely than CT or MRI alone.

Tall_Allen profile image
Tall_Allen in reply tomperloe

It's not very good at finding lower grade prostate cancer within the prostate. mpMRI is much better. In fact, the false positive rate is so high that it's worse than a coin toss. The false negative rate is very low, so it's better at ruling cancer OUT than ruling it IN.

mperloe profile image
mperloe in reply toTall_Allen

My case MRI suggested Tulsa Pro would be fine with PSA 4, GL4+3, I delayed PET until after Tulsa Pro due to Covid and found high SUV in seminal vesicle. If we can identify direct extension or distant spread initial treatment can be better tailored. PET will not likely replace MRI, but may be selected for some .

Tall_Allen profile image
Tall_Allen in reply tomperloe

TULSA-PRO doesn't work anyway. It's good that you weren't able to use it:

prostatecancer.news/2021/03...

mperloe profile image
mperloe in reply toTall_Allen

Unfortunately I did use it and found I needed to to SBRT three months and $30k later.

Tall_Allen profile image
Tall_Allen in reply tomperloe

Yikes!! I hate how they oversell that stuff!

mperloe profile image
mperloe in reply toTall_Allen

And, it should be restricted at best to GL 3+4, not 4+3. Not sure most know it was not studied in GL4+3 and is not approved for treating prostate cancer.

Tall_Allen profile image
Tall_Allen in reply tomperloe

It should only be allowed in a clinical trial where patients are informed in writing what the experience has been.

tallguy2 profile image
tallguy2

Thanks for posting this. I had my first PSMA-PET three weeks ago in prep for my latest clinical trial. It was an eye opener.

Tall_Allen profile image
Tall_Allen in reply totallguy2

This is a BiTE trial?So lots of psma to latch onto is good?

tallguy2 profile image
tallguy2 in reply toTall_Allen

Yes, BiTE. Absolutely one of the drugs turned on my immune system to go after anything expressing PSMA. Got dry mouth as it turns out the salivary glands express PSMA. Will know in 6 weeks how things are going. But I went into the hospital with blood clots and blood in my urine thanks to a 1” x 2” PCa met in the bladder. Cleared up.

Tall_Allen profile image
Tall_Allen in reply totallguy2

Unfortunately PSMA isn't as specific to prostate cancer as we would like it to be. The tissue in salivary glands, tear ducts and kidneys express it. In pre-clinical study, pretreatment with the PSMA-11 ligand was able to reduce damage to salivary glands without reducing effectiveness of the Ac225-PSMA radiopharmaceutical. Maybe it will work for BiTE too.

prostatecancer.news/2021/01...

tallguy2 profile image
tallguy2 in reply toTall_Allen

I want to add that I feel extremely blessed to have been selected for this trial.

Tony666 profile image
Tony666

I want to highlight what tall Allen said about the danger of “false positives” since PSMA is expressed by other things besides prostate cancer. I was in an NIH trial for this scan last year with high risk (Gleason 9) prostate cancer. The scans found psma in 2 ribs which were ultimately not determined to be cancer but which gave me a lot of worry. For this reason, I think this should only be used if you are pretty sure you have metastatic rather than at the start of your journey.

in reply toTony666

Yeah, but ... when your PSA is creeping up there's something going on, so where is it?

in reply toTony666

How did they ultimately determine they did not represent metastatic lesions?

Gabby643 profile image
Gabby643

Good News, thanks!

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