What is the recommended treatment after 6 Pluvicto doses?

Posted by donalan @donalan, Mar 13, 2023

I will have had 6 Pluvicto doses next month. PSA has decreased some. SE have been much easier to tolerate than chemotherapy. What is the recommended maintenance treatment after receiving Pluvicto?

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@lag

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.

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Who is his oncologist at Simon?

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@smc24

Who is his oncologist at Simon?

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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.

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I also have Adra and I am very pleased.

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@larke

No initial delay. Completed the usual 6 treatments, six weeks apart. Relative success: PSA 75 to 8. March 13 completed.
Agreed to be a test case for MORE Pluvicto and will likely begin in early August. Likely two or three applications.
Larke

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How's the trial of more Pluvicto going?

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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.

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@smc24

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.

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It sounds like the current Pluvicto infusion protocol is different than the one that was used during the original clinical trial you were in. What you had last Tuesday is exactly the same protocol as my husband has had at Mayo Rochester since January 2024. He is just infused with the Pluvicto, no other medications before or during the infusion, and told afterward to use the Zofran and/or Miralax as needed if those side effects occur. Your fatigue and slight nausea and touchy stomach are the same very common side effects my husband had after his first Pluvicto infusion. They did lessen with each subsequent infusion. So hang in there!

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Very helpful discussion, thank youth all. I am 3.9 years in/w APC (Advanced Prostate cancer), PSA is rising, but I've learned over time PSA is a good indicator that moves occasionally and carries lots of emotional baggage from my big one, 118, 3.11 years ago. I enter the Pluvicto orbit next week with first oncologist session/discussion about it. Oncology nurse called yesterday and explained/outlined the entire process.

So helpful.

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@proftom2

Very helpful discussion, thank youth all. I am 3.9 years in/w APC (Advanced Prostate cancer), PSA is rising, but I've learned over time PSA is a good indicator that moves occasionally and carries lots of emotional baggage from my big one, 118, 3.11 years ago. I enter the Pluvicto orbit next week with first oncologist session/discussion about it. Oncology nurse called yesterday and explained/outlined the entire process.

So helpful.

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Please keep us posted and feel free to ask any questions you have as you progress through the Pluvicto infusions. We are all happy to share our experiences and what we have learned going through the treatments. And good luck to you!

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@smc24

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.

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Odd, my 6 Pluvicto treatments were administered without additional medication or ice chips. Is your dose the same as the first 6 treatments?
My PSA entered Pluvicto at 10.8 and ended at 0.15. Waiting for latest PSA and PET to be shared next week. Side effects were minimal until #6 then slight nausea.
Following with interest for a follow up possibilities.

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