Can anyone share their experience with Pluvicto?

Posted by vcash @vcash, Apr 22, 2024

My 85 year old dad has prostate cancer that has metastasized to his bones. Zytiga is no longer effective. He is considering Pluvicto. I would appreciate input from those who have used Pluvicto.

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Profile picture for shz @shz

@jeffmarc
What if you have PTen and TP53 as well as ATM and BRCA?

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@shz
Got to admit, that’s a lot of genetic issues.

Are all 4 really found in one person?

I would not even try to make a guess.

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Profile picture for michaelbryan6998 @michaelbryan6998

79 years young with metastacized Prostate Cancer in my ribs & backbone. I also have IPF. I have been dealing with the cancer for 4 plus years. Chemo, ADT, direct radiation to the prostate, and now I"ve had two rounds of Pluvicto. Side effects: tiredness (to add to the effect from all the meds), dry mouth, increasing discomfort in my bowels, and a gnawing question about whether its working. My doc won't do another PSMA scan till after the 4th treatment which is frustrating - only way to know if its working or not. No pain from injection - hassle keeping distance from my wife and sleeping in separate rooms ( we like each other) but the tiredness increases and I wonder about other side effects. Thought it good news (at least for the drug company) that they have now approved it for use without chemo or ADT - the idea is great and hope its working and killing the cancer cells. Choose life, fight, fight, fight.

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@michaelbryan6998
Michael, I hope that you've now had that fourth round of Pluvicto and the PSMA PET scan is now scheduled. I'm 77 years young, extensive mets, heart and other comorbidities, but taking it all as it comes and making the most of each day. Keep on keeping on.

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Profile picture for jimw77 @jimw77

@michaelbryan6998
Michael, I hope that you've now had that fourth round of Pluvicto and the PSMA PET scan is now scheduled. I'm 77 years young, extensive mets, heart and other comorbidities, but taking it all as it comes and making the most of each day. Keep on keeping on.

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@jimw77

thank you for your good thoughts. Pluvicto is on hold due to other medical issues, and yes, one day at a time and it all belongs to Him.

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I'm 74 and have had stage 4 gleason 9 for 7+ years, and am on hormone therapy with a total of 45+ days of radiation. So far God's blessed me with a great oncologist and a great radiologist. Each time the identified areas of metastasized get addressed.
now I started my PLUVICTO treatment and only 14 days out and I still feel like crap. Max fatigue. Almost like my muscles and bones don't want to operate anymore. I can go for a daily 2 mile walk and I'm wiped out through 1/2 of the day. The last 4 days seems to have impacted my bowel movement as I have had to use the bathroom about every 30-40 minutes. Stools have been very very muddy (sorry to share). I'm getting about an average of 5 hrs sleep a nite and sruggle to fall asleep (if a all) again.
Nausea that just won't go away. I actually believe the anti nausea meds makes me feel worse. My next treatment is around Dec 21 (Merry Christmas!) and maybe i'll get a surprise gift.

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Some people react too strongly to Pluvicto and can’t continue with it.

Other people need to have a lower dose or have more time between Infusions.

You need to talk to your radiation oncologist about this problem. It is a very strong reaction and unusual. Get the doctor’s opinion on what to do next.

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Profile picture for gtgitha @gtgitha

Hello. I’m the widow of a Pluvicto treated Awesome Godly Man! He was advised to have the chemo before the Pluvicto. Don’t tell my husband Not to do something. He was Always “game on,” when it came to his cancer treatment. Granted he was a 20+ year survivor of Melanoma-from 2002-do I need to tell you BRCA2. Anyway, he passed away 9/11/2024; yet retired from full time work 9/1/2024, although bedridden Hospice at that point. Driving and working until 8/9/2024. He completed his last Pluvicto #6 on 5/14/2024. He had absolutely no side effects from Pluvicto, especially when we realized Zofran caused constipation and told his team he wasn’t taking the Zofran. The “chemo wrecked me.”
There’s So much more to his story, but fight fight fight is what my husband chose to do and we supported him all the way. He was 68 years old. I was an Emergency nurse for 30+ years and a Hospice nurse 41 years ago. Every single human is different. Godspeed and blessings to all of you.

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@gtgitha
Greetings. I, also, am the wife of a pig-headed man. He was diagnosed Grade 5, Gleason score of 9 last December, with 5 initial mets sites to bones. He takes Nubeqa BID and gets injections of Lupron every 3 months. He did chemo (Taxotere, ending in May), and radiation on the prostate with concentrated radiation to 2 new bone sites - that grew during chemotherapy - in September. Good results from radiation overall, but 2 new sites popped up; next scan in April - at which time Pluvicto is the choice, if there are additional sites. That is why I am beginning earnest research now. I am a retired ER nurse as well, and very much appreciate your post!
Hope you are well and wishing you peace - Mary

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Profile picture for redroadtraveler @redroadtraveler

I am 80 years old with stage IV prostate cancer which has metasasized throughout my bones. Been on various immunotherapy treatments for 3-4 years (most recent being Keytruda). All of them have run their course and are no longer effective.

I tried for several months to get the Pluvicto treatment but they didn't do it due to the FDA saying a person had to have had chemotherapy first. I elected to NOT have chemotherapy as it made no sense to me to kill off everything and hope that the good comes back faster than the bad.

Very recently, the manufacturer began to question the necessity for chemotherapy prior to Pluvicto and I am one of the first people to get Pluvicto without having had chemotherapy.

Pluvicto treatment protocol is an IV injection every six weeks for a total of six times. It is a heavy duty radiation treatment but it is NOT chemotherapy. It targets the cancer cells instead of the shotgun approach of chemotherapy.

I am halfway through my Pluvicto treatment. I have had three injections and will get number four in a week.

You will get detailed scans prior to the treatment, and the doctor will monitor your blood work closely and see how you are tolerating treatment before giving you the next injection.

After the injection, they turn you loose when your radiation level is three at a distance of three feet.

We joke that I "glow in the dark" after the injection but there is a certain amount of truth in that. I wanted this treatment for myself, but was concerned about "collateral damage" of radiation to anyone else around me. The official guidelines tell you to maintain a three foot distance from everyone for three days, and for seven days from pregnant women and small children (and by extension small animals like cats or dogs).

Every radioactive substance has a half-life and decays over time. I purchased a dosimeter (Geiger counter) from Amazon for about $100 to monitor my actual condition rather than simply going by their guidelines.

My personal experience is that, for me, the guidelines are not strict enough. I do not want to cause collateral radiation damage to anyone else, so monitor my radiation level daily at three feet, one and a half feet, and right next to my skin.

My personal protocol is to isolate myself for one week. I am alone in the bedroom, reading, binge watching Netflix, etc., leaving only briefly to get something to eat or go to the bathroom.

During week two I loosen up a bit, allowing brief contact such as a hug or a handshake, but no prolonged contact.

By the end of two weeks from my injection, my personal radiation level is down to zero at my skin, so I no longer have any danger of giving collateral radiation damage to anyone. At that point I resume sleeping in the same bed with my wife and have no issues with personal contact with others.

Everyone reacts differently to different treatments. I have tolerated it reasonably well. The worst side effect has been serious constipation. Also a moderate increase in fatigue.

I would like to get another scan now, halfway through treatment, but insurance won't pay for it. I will get another scan when all treatments are done so I will at least have a before and after reading on how effective (or ineffective) it has been.

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@redroadtraveler
Hello Redroad! I've just joined the group, and am hoping that you are still fighting the fight.
I am a retired ER nurse and I just want to let you know how dead-on informative your post was!
My husband was diagnosed last December, is on hormone therapy, and has been through chemo and radiation. Next scan is in April, and we may be looking at Pluvitco at that time.
I had not even thought about our cats - thank you for that! Your post was so thorough, you must have been an engineer!

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Profile picture for shawnswife @shawnswife

@gtgitha
Greetings. I, also, am the wife of a pig-headed man. He was diagnosed Grade 5, Gleason score of 9 last December, with 5 initial mets sites to bones. He takes Nubeqa BID and gets injections of Lupron every 3 months. He did chemo (Taxotere, ending in May), and radiation on the prostate with concentrated radiation to 2 new bone sites - that grew during chemotherapy - in September. Good results from radiation overall, but 2 new sites popped up; next scan in April - at which time Pluvicto is the choice, if there are additional sites. That is why I am beginning earnest research now. I am a retired ER nurse as well, and very much appreciate your post!
Hope you are well and wishing you peace - Mary

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@shawnswife
Is there some reason they haven’t used SBRT radiation to zap those two new Mets that came up?

Usually, you will go to Pluvicto if you have multiple mets besides those two that you mentioned. You do say if there are additional sites, did chemo not eliminate all that were there?

A lot of doctors think that just zapping them as they come up is the best treatment.

We’re all hoping for the Best for your husband. Nice to have a wife who is a nurse too be the caregiver.

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Profile picture for shawnswife @shawnswife

@gtgitha
Greetings. I, also, am the wife of a pig-headed man. He was diagnosed Grade 5, Gleason score of 9 last December, with 5 initial mets sites to bones. He takes Nubeqa BID and gets injections of Lupron every 3 months. He did chemo (Taxotere, ending in May), and radiation on the prostate with concentrated radiation to 2 new bone sites - that grew during chemotherapy - in September. Good results from radiation overall, but 2 new sites popped up; next scan in April - at which time Pluvicto is the choice, if there are additional sites. That is why I am beginning earnest research now. I am a retired ER nurse as well, and very much appreciate your post!
Hope you are well and wishing you peace - Mary

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@shawnswife, I'm tagging @lag to bring her into this discussion with you Mary. Her husband was treated with Pluvicto and she may have some tips to share.

Do you have specific questions?

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I have just had my third Pluvicto infusion and have had no problems other than fatigue and some constipation. However, I have developed something else which I don't whether is connected to the treatment or not. My wife and I usually like to have wine with dinner. Prior to the Pluvicto, I had no problems with this. Recently though, I have found that after my usual two glasses, I feel extremely dizzy and sick if I stand up (if I remain seated, there is no problem). I tried cutting back to one glass and, although not as bad, the effect remains. Has anyone else had this happen?

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