What is the recommended treatment after 6 Pluvicto doses?

Dear smc24,
Where are you having another six Pluvicto treatments starting next week? I apologize if you posted that information somewhere and I missed it.

Simon Cancer Center, Indiana University Health Indianapolis will be administering this second and unprecedented round of treatments starting early September 2024. I was one of the original clinical trial patients at the University of Chicago in 2021-22. My response was miraculous. It was identified as PMSA 617 Lu177 which has now been approved in the US under the name Pluvicto. I was given just a few months to live with extensive stage 4 metastatic prostate cancer just prior to starting. It has now been more than 2 years before tumors were growing again and PSA rose. The IUH and U of C oncologists knew each other. The repeat is essentially considered another trial, although not a formal trial, as we find no patient data on repeating the treatment.
Other options were considered, but this seems to be the best for me. I've had most all standard protocol treatments, and more for 10 years.

Thanks so much, smc24. My husband's medical oncologist is at Simon in Indianapolis, though my husband chose to have his Pluvicto treatments at Mayo Rochester instead, over my objections. (I objected because we live about an hour from Simon and ten-plus hours by car from Rochester.) My husband just finished his sixth Pluvicto on August 14, whereas you finished what is now known as Pluvicto in the original clinical trial years ago, and I suppose that might make a difference in whether my husband would be considered for another round any time soon. He has a scan on September 25 to show how effective Pluvicto has been against his many metastases.

My first round costs were covered by the pharmaceutical company in the trial. No insurance involved. Now. Medicare and my supplemental insurer will pay.
The two year period between the end of the first round and the start of the repeat treatments was a definate factor in my medical staff's decision to move forward with this treatment. FYI, I had ARC targeted beam radiation on a few problematic tumors this spring prior to this decision. It helped, but just kicked the can down the road a little more.
Stay in touch.

Thanks so much once again, smc24. My husband also had some spot radiation and then an ablation to a spot on his spine before starting Pluvicto. As you say, it just kicked the can down the road. His next appointment with his medical oncologist at Simon is late October. I may try to contact him before that, depending on what the September 25 scan shows. I will definitely keep you posted.

Who is his oncologist at Simon?

He started with Dr. Albany years ago, but he left IU Health. My husband's current medical oncologist at Simon is Nabil Adra. We have liked them both very much.

I also have Adra and I am very pleased.

How's the trial of more Pluvicto going?

The first of the repeat Pluvicto treatments (7 now) was administered last Tuesday. Same drugs as the original clinical trial, but the two are combined in one infusion resulting in half the time spent in the hospital.
Oddly, there were a couple of differences I somewhat question. One is, no ice chips or neck ice pack was considered to reduce injury to the saliva glands. I had them provide me a cup of ice chips. Another difference, no Pepsid, Benadryl and Zofran were administered prior to the infusion which were always given in the clinical trial. I had slight nausea, stomach ache and fatigue the two following days. I'll take my own meds next time.
I monitor myself with a geiger counter and can determine the uptake and declining radiation. I will compare these readings with my original clinical trial numbers. More bloodwork will be performed in 4 weeks.