Can anyone share their experience with Pluvicto?

Doing Pluvicto A second or third time is not unusual. In Australia, it has become more common. You should ask about the possibility of having it a second time. I’m surprised that they pulled you off chemo after two different tries and the PSA not dropping below 13. I’ve heard that from many people, but when they continue with it, it does work for some of the people. I know people have had their PSA rise after having a second or third chemo session, Only to have a drop After later sessions.

Ask your doctor about it, Would it make sense to try it again?

After Xtandi no longer worked and after my husband's first Pluvicto, his PSA rose to over 1,300. In a telemed appointment this morning, the nuclear medicine specialist suggested we consider hospice. I was shocked. A second Pluvicto treatment is scheduled in two weeks, and neither my husband nor I are ready to give up. He is often tired and his legs are weak, but he gets up every morning, comes down a flight of stairs and eats breakfast. Watches a lot of tv, plays his guitars and spends his days like many retired people do. I think we should at least wait until we're sure Pluvicto isn't reducing the cancer at all before giving up treatment other than pain meds. He doesn't need a hospital bed and/or visiting nurse. What do you other cancer patients think?

Some people have some major side effects from Pluvicto, most don’t. I have heard at least 5 people talk about their experience, In some cases they had to have more time between doses because of the side effects.

I saw a webinar where they discussed a person who lit up the Pet scan With metastasis from head to Legs. He had one Pluvicto Treatment and it almost cleared his pet scan, But his side effects were so bad that he could not take any more treatments

Be aware that it works really well for 33% of people OK for 33% of people and not at all for 33% of people.

If you have certain genetic issues, either hereditary or somatic, it can affect how well Pluvicto Works. You can ask for a somatic test before doing Pluvicto To find out if you’ve got Genetic changes Due to the cancer.

If you have BRCA2 or ATM It seems to work better. If you have RB1, PTEN or TP53 They are Pluvicto resistant. I don’t know if these are the only hereditary changes that cause Pluvicto to work much better or more poorly.

If you have not had a hereditary test, I can give you the Website of a Study where you can get it for free.

My situation is similar. I completed 6 Pluvicto treatments Feb.2024 and psa stayed around .2 for 11 months.
Now psa is 4.6 which is doubling each month.
MO says I'm in uncharted waters and is still not sure of treatment options.
I can not afford the cost of re-treatment of Pluvicto and FDA has not approved beyond six treatments.
Anyone with treatment ideas is appreciated.

We are in similar situations. My Oncologist suggested we start a different Chemo which I hesitate due to how good I feel. I have a MRI for Pelvis and another for Femur scheduled for 4/07 and 4/15. Recent Bone Scan (3/03-04) was great, but with PSA increasing, I allowed "Jevtana" to be started on 3/26.
My Wife could no longer live with the Cancer and died by her own hand, which has reduced my self advocacy a bit, but I'm still in the game and will fight on. Pluvicto was a miracle for me. The treatment gave me another 18 months of myself back. I too had hoped to have a second round of Pluvicto. Fight on my Friend! Keep sharing findings........God Bless

My husband just celebrated 62-Diagnosed July '24 w Advanced (pelvic,Lymph, spine & scapula) completed 6 chem(completed 12/24), on Nubeqa and harmone injection every 3mos- PSA 1.02 2/25, Scan showed-not lit up in spine but still in Pelvic area
PSA today-1.66- Pain has moved from Pelvic to spine today!
Oncologist visit today-she is concerned- as pain has increased to spine and PSA has increased- she is recommending Pluvicto , and talks about 2-3 years life span..... I am trying to be a strong partner, this is the second cancer we are facing(Tonsil cancer in 2020) I cant stand to see the suffering, Hydrocodone brings some relief-last night he had a brutal nite- this is a nightmare.......

One next step could be chemo. After Pluvicto cabazitaxel and carboplatinum.

Ask your doctor.

@foamhand May I ask how you got approved for an additional 6 doses?
My husband has been on a similar journey (12 years with bone Mets, doing his first round of Pluvitco Sep 23 - May 24). He had great results from Pluvitco. PSA’s starting to double each month & a second round is being discussed. He’s a little older, so on Medicare & I don’t believe they cover another round. Any insight would be appreciated

Here is i’d answer, though it may not be really satisfactory.

Medicare may provide payment for a second round of Pluvicto, but coverage depends on your specific Medicare plan and whether the treatment is deemed medically necessary. Medicare does not have a National Coverage Determination (NCD) for Pluvicto, so coverage decisions may rely on Local Coverage Determinations (LCDs) or individual assessments. Additionally, prior authorization may be required, and the coding process can affect payment timelines.
To confirm coverage for a second round, consult your Medicare plan provider or the Medicare Coverage Database.

We have consistently been told at Mayo Rochester and by our local medical oncologist that there is no approval in the US for more than six Pluvicto infusions, and my husband's Original Medicare plan and Anthem supplement are still saying they won't pay for additional infusions for that reason. You need to check to see if your specific coverage and plans somehow cover it, and your medical team would need to do the prior authorization, so check with them to see what they say.