Can anyone share their experience with Pluvicto?

The FDA has only authorized six infusions of Pluvicto for the United States. Other countries permit additional rounds. And some few oncologists in the US are giving another round of six under a rubric that is unclear; maybe a clinical trial or some emergency authorization they can get? The Kwon team at Mayo Rochester just told us they are not giving more than one round of six. As for Medicare or private insurance, I have no idea how the extra round is paid for.

Haven't gotten to the question yet of if it is advisable to start on a second round of Pluvicto what the insurance situation is.

Here is my personal situation. I was a clinical trial patient for Norvartis Pharmaceutical in 2021-22 for what became Pluvicto. No insurance was involved. 2 years later, the prostate cancer has returned and I am going through the same 6 Pluvicto treatments again, but this time Medicare and my private insurance in paying. My oncology group worked with and obtained approval from the insurance providers.
So, I'm assuming insurance would NOT pay for the treatments twice (6+6=12). I have heard of, but do not know of anyone personally, except myself repeating the treatments.
Six teatments are about $300,000 plus peripheral costs of maybe $25,000-50,000.

Thank you for this information. My husband is on Medicare and 6 treatments are what they have approved. I have not heard of any private insurance companies that would cover more treatments.

Did it work What is PSA What is status of PC metaseries Bone?

Pluvicto was started as my PSA abruptly increased from a low of 8 after doxetaxel treatment to 17 a few months later. By the time Pluvicto was started the PSA was 198.
After the first infusion, the PSA dropped to 100. After the second infusion, up again to 120. After the third infusion, the PSA was 364 - obviously a treatment failure. Options now are essentially nonexistent. I am unwilling to accept the debilitating side effects of a repeat doxetaxel ( or other chemo agent) for minimal short term benefit.

Study PSA flare with both Chemo and 177

COPY Overall, 125 patients were included. Median PFS and OS were 6.5 and 13.3 months, respectively. Depending upon the definition used, flare incidence ranged from 8.3% to 30.6%. The flare lasted < 2.6 months. A PSA flare followed by a ⩾50% decrease was associated with a median PFS and OS of 11.2 and 25.2 months, respectively. Median PFS and OS for a ⩾30% rather than ⩾50% decrease were 10.4 and 16.5 months. These outcomes were not significantly different from those in patients with immediate PSA decreases of ⩾50% or ⩾30% from baseline, but were significantly better than in patients experiencing no PSA decrease (p = 0.006 and 0.015, respectively, for OS).
Conclusion
The PSA response to cabazitaxel, with or without initial flare, was associated with a strong survival benefit. The taxane-induced flare during the first 12 weeks of therapy can be ignored when evaluating PSA response.

A prostate-specific antigen (PSA) flare occurs in about 15% of metastatic castration-resistant prostate cancer (mCRPC) patients receiving docetaxel. This flare has no standard definition. Its impact on treatment efficacy is unclear. We sought to evaluate the incidence and characteristics of PSA flare on cabazitaxel, and its impact on survival.
https://www.sciencedirect.com/science/article/abs/pii/S0959804914002706#:~:text=A%20prostate%2Dspecific%20antigen%20(PSA,on%20treatment%20efficacy%20is%20unclear.
BTW my PSA flared from 41 to 159.3 Oncologists said must do 12 weeks then see just did second chemo I am 80 and feel great Mets in T5 and L4 and hip Pain first 4 days but on pain killer's Tylenol and some more powerful Options arc 177 or clinical trial OS maybe 13 to 25 months

WHAT about chemo with Cob?> Or this What is the most powerful chemo drug?
Red Devil Chemo: What to Know About Doxorubicin
Doxorubicin is one of the most powerful chemotherapy options for a wide range of cancers. Because of the way it works, doxorubicin can kill cancer cells at any point in their life cycle.Sep 28, 2023

Thank you for sharing! Mine is similar, and yet I am still fighting as you are! Stay strong!