How many years does Pluvicto extend overall survival

"How many years does Pluvicto extend overall survival?"

If you look at the VISION trial, the answer is "a median improvement of 4 months".

But I wouldn't interpret that too narrowly: everyone in the trial had metastatic cancer that had reached castrate resistance, then had received chemo at least once, and in many cases (I'd guess) was receiving Pluvicto as a final hail-Mary because the chemo had failed to stop the cancer from progressing. Also, half of the patients still did better than 4 months (many, perhaps a *lot* better), and there was no upper age limit for the trial that I can find, so a non-trivial portion of the participants likely died of something other than prostate cancer.

So don't be discouraged by that number, because interpreting stats is tricky.
https://www.nejm.org/doi/full/10.1056/NEJMoa2107322

Call me a frustrated researcher. The 'HIGH'-er metastatic risk Gleason scores and NCCN recommendations have not anticipated the newer technology's effects. I believe the G9 five year period free of micro mets is about 75-80%; In the remainder or about 20% who have 1-5 yrs micromets rate about 60% involve one lymph node, another 22% two lymph nodes. both are amenable to spot SBRT that resets the 'clock' as it were. It is my understanding that the base reference G7, 8, and 9 prognostications were derived post radical prostatectomy. In that context wouldn't PLUVICTO or the other emerging systemic radiotherapeutic ligands make a nice control versus 'preventive' lymph node irradiation for newbies in the 'HIGH'-er metastatic risk categories?

Darned good question! I initially thought it was only for bone metastasis, but that’s not the case.
They use it for soft tissue areas as well. However, it will only target cells which express PSMA and many PCa’s do not.
But it would be revolutionary to have a ligand therapy that homes in on a ‘universal’ cancer marker and attacks ONLY the cancer and not every cell from your navel to your pelvis.
Phil

I ask this question because I have not heard of anyone that has had Pluvicto say it has extended their life more 2 years or so and that is discouraging. I also do not think it is true either. There has to be success stories out there that can says, "Hey, I had pluvicto more than 2 years ago and I am fine."

Pluvicto was approved for medical use in the U.S. and Canada in 2022. So it's reasonable to assume that most people who've received it (outside of a trial) haven't had time to live more than 2 years yet. Hang tight! 😉

I was in the 2021-22 Pluvicto clinical trial in the US. At that time, and I believe this is still the case, Pluvicto was shown to "extend life 11 to 15 months".
It knocked my cancer back for 22 months. I then received ARC targeted beam on three troublesome tumors. That helped for a few more months. I was then selected to repeat the full 6 Pluvicto treatments starting in the fall of 2024. After 4 of the repeat 6 treatments, it again has greatly reduced the cancer, related tumors, etc. and I am doing great. So good, the last 2 treatments have been paused for the last 4 months. I will receive the remaining 2 when needed, hopefully not before mid 2026.
So, to summarize my response to a couple of questions, 11 to 15 months and I am a lucky patient who has responded extremely positively and doing as well as most any Pluvicto patient.
Good luck, do your research.

Your recollection is correct about the 15 months, but that was total overall survival, not the difference. In the VISION trial, patients on Pluvicto had a median overall survival of 15.3 months, while patients in the control group (no Pluvicto) had a media overall survival of 11.3 months, so the median additional OS was 4 months.

Again, as your experience shows, it's best not to take that too literally.

Systemic radiotherapeutic ligand therapy such as Pluvicto had been reserved for those who had chemotherapy but now as of May 2025 its authorization no longer requires that step. What will be the next down? I assume it will be authorized for those with metastatic disease but are still hormone sensitive. Then oligometastatic ds, then 1 or two lymph node...next down to G8, 9 and 10. with a negative PSMA CT PET scan. Then unfavorable 7 (4+3). By then there may be a therapeutic vaccine. Ours is a slower ds.

BTW: Oregon State Health System has come up with $0.25 blood test for early pancreatic cancer diagnosis to be confirmed on a larger group. Another center has very promising initial results for a therapeutic vaccine against pancreatic cancer. Hold on boys the cavalry is on the way.

“A vaccine against pancreatic cancer…”.
Amazing.
Phil