I am puzzled by your comments
“ The first of several in the pipeline is PLUVICTO (PSMA Lutetium 177). (It is a 'first cousin of the substance in a PSMA PET-CT scan) Some well off individuals are resorting to medical tourism, going to Germany, India etc. to get the infusions of PLUVICTO. ”
Pluvicto has been available in the United States for years and is FDA approved and paid for by insurance. Actinium-225 Is what people are going over to Europe to get infusions of since it is not approved in the United States. I know somebody that actually went to Austria to have it done.
“Adding neoadjuvant ADT (androgen deprivation therapy) increases that sensitivity by 67%, (There is some thought that adding Nubeqa brings the sensitivity to 100% of the baseline?)“
I have looked into this and find that the percentage vary a lot Based on the case. Where did you get the information about ADT increasing sensitivity by 67%? I’d like to be able to quote that information and also the addition of Nubeqa.
What I have read is this
“ In summary, ADT enhances the effectiveness of radiation therapy however, the exact magnitude of the improvement varies depending on the specific clinical scenario.”
I may have misled people into thinking Pluvicto was only available overseas for rich folks. My intention was to say it is available overseas for those who do not meet the criteria for insurance payment, The requirement for prior chemo was lifted for castration resistance this Spring. I assume that it will devolve down to hormone sensitive ...etc. In New Delhi a very modern hospital is offering Pluvicto for USD 47K for the series. In principle the cancer within the capsule without metastases should be as sensitive to ligand radiotherapy if not more so?
With regard to an additive benefit of Nubeqa to ADT prior
to radiotherapy I cannot find the notice. There is however
a benefit apparently for a planned prostatectomy (RP).
Bayer just did make an announcement that the FDA had approved 03 June that Nubeqa has been approved for hormone sensitive metastatic disease.
https://www.bayer.com/en/us/news-stories/metastatic-castration-sensitive-prostate-cancer