Pluvicto Prognosis

Posted by cal77 @cal77, 4 days ago

Hi,

They are thinking of trying Pluvicto with my husband. What is the prognosis with this? When I googled it, I read 15 months increased survival! That doesn't sound very good to me..
Anyone had Pluvicto? How are you doing?
This is all so scary...What about Immunotherapy for Stage 4 Prostate cancer? His PSA is up to 500, although 2 weeks ago it dropped to 490 and didn't increase..so we were thankful for that..
Thanks,

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Profile picture for Jeff Marchi @jeffmarc

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.

One person I know Peter who runs the advanced prostate cancer reluctant brotherhood forum has had prostate cancer for 12 years. He’s had every treatment. He had the last one possible, Pluvicto, About six months ago. After three treatments, his PSA went down around .05. It has stayed close to that since. For some people, it works really well for other people. It doesn’t work as well. You just have to try it and see how well it works for your husband.

Here’s some feedback from people at Mayo
https://connect.mayoclinic.org/comment/1380711/
https://connect.mayoclinic.org/discussion/can-anyone-share-their-experience-with-pluvicto/

Jump to this post

@jeffmarc Thank you for attaching those threads, as I am looking for information on Pluvicto "experiences".
Shawn had his latest PMSA PET yesterday and we meet with his oncologist tomorrow. The expectation/plan is to start Pluvicto, as Shawn now has 10 metastasis sites (1 lymph nodes, 9 bones; primarily ribs and spine).

REPLY
Profile picture for Jeff Marchi @jeffmarc

@brbriggs
The SUV scores are not the important thing most people talk about when they are about to have Pluvicto. The more spoken about issue is how many metastasis they have. Those always have a high SUV score. If somebody has multiple metastasis then Pluvicto is a good treatment to try before chemo since it has fewer side effects.

The salivary glands have a high SUV because they do produce PSMA. That does bring up one of the problems with Pluvicto, It reduces the amount of saliva you produce, and that can be a real problem when it comes to eating. Actinium, the alpha treatment is even worse on the salivary glands.

A Four or five SUV would not really imply a metastasis. You may get that on a Rib, but that is unreliable since injuries to the ribs can cause that. I broke a rib in my 20s and that always shows up.

Jump to this post

@jeffmarc Thanks for replying so quickly. The SUV scores were of cancer sites outside of my prostate. I tend to have just a few sites at a time (since completing Chemo two years ago) and been using x-ray radiation to kill them off. However, earlier this year I had the treatment on four sites and my PSA score went down from 12 to 0.7 and then immediately started rising again. I am scheduled for another PSMA PET scan in a couple of weeks, so I will find out what is going on and what my new SUV scores would be.

REPLY
Profile picture for brbriggs @brbriggs

@jeffmarc Thanks for replying so quickly. The SUV scores were of cancer sites outside of my prostate. I tend to have just a few sites at a time (since completing Chemo two years ago) and been using x-ray radiation to kill them off. However, earlier this year I had the treatment on four sites and my PSA score went down from 12 to 0.7 and then immediately started rising again. I am scheduled for another PSMA PET scan in a couple of weeks, so I will find out what is going on and what my new SUV scores would be.

Jump to this post

@brbriggs
SUV 4 and 5 can be problematic, sounds like your hot spots were that low. Those can be moderately aggressive, Interesting that they made such a difference when zapped. Usually takes 10 or more to really be serious malignancy.

Definitely sounds like time to get another PSMA PET scan. At least what you’re doing is working And your PSA drops significantly when you have the treatment.

REPLY
Profile picture for Jeff Marchi @jeffmarc

@brbriggs
SUV 4 and 5 can be problematic, sounds like your hot spots were that low. Those can be moderately aggressive, Interesting that they made such a difference when zapped. Usually takes 10 or more to really be serious malignancy.

Definitely sounds like time to get another PSMA PET scan. At least what you’re doing is working And your PSA drops significantly when you have the treatment.

Jump to this post

@jeffmarc The four spots were zapped five times with x-rays.

REPLY
Profile picture for brbriggs @brbriggs

@jeffmarc The four spots were zapped five times with x-rays.

Jump to this post

@brbriggs
Actually, they zapped them with SBRT radiation. It is quite different from x-rays Which aren’t used for metastasis treatment?

REPLY

Interesting reading, as usual...CAl77 had it best...it's new, so there's not a lot of empirical data.

I'm starting after PET-PSMA showed activity in the bone and the prostate after being quiet (no abnormal hypermetabolic activity) for 2 years...T is still low (18). My Doctor and I chose Pluvicto rather than Xofigo because of the metastasis to soft tissue as well as the bone (L4).

I'm starting next Tuesday and await the treatment. I, too, have been through all the series of different treatments and, although the new SUV was relatively low, I can't take any chances...It's, as I've said before, a 'crap-shoot'..."darned if you do, darned if you don't".

I also have the questions about the info from the manufacturer..."15.3 months vs. 11 months"...What the hell is that supposed to mean??? If I had 11 months to live and my Doc didn't tell me that, I'd be pissed!!!

I have to read that in terms of extending my lifespan...NOT in terms of months, but by percentages...

I'll keep y'all posted as to the results...Oh, it's not going to be the PSA solely, rather the scan after ...3-4 treatments...

Blessings to all

REPLY
Profile picture for deccakid @deccakid

Interesting reading, as usual...CAl77 had it best...it's new, so there's not a lot of empirical data.

I'm starting after PET-PSMA showed activity in the bone and the prostate after being quiet (no abnormal hypermetabolic activity) for 2 years...T is still low (18). My Doctor and I chose Pluvicto rather than Xofigo because of the metastasis to soft tissue as well as the bone (L4).

I'm starting next Tuesday and await the treatment. I, too, have been through all the series of different treatments and, although the new SUV was relatively low, I can't take any chances...It's, as I've said before, a 'crap-shoot'..."darned if you do, darned if you don't".

I also have the questions about the info from the manufacturer..."15.3 months vs. 11 months"...What the hell is that supposed to mean??? If I had 11 months to live and my Doc didn't tell me that, I'd be pissed!!!

I have to read that in terms of extending my lifespan...NOT in terms of months, but by percentages...

I'll keep y'all posted as to the results...Oh, it's not going to be the PSA solely, rather the scan after ...3-4 treatments...

Blessings to all

Jump to this post

@deccakid wrote ❝I also have the questions about the info from the manufacturer..."15.3 months vs. 11 months"...What the hell is that supposed to mean??? If I had 11 months to live and my Doc didn't tell me that, I'd be pissed!!!❞

And I'll just repeat that while the median is useful for quantitative comparisons in a time-limited clinical trial, it doesn't tell us much as patients.

Here's a simple (albeit extreme) example: let's say we have 9 patients in the study group in a tiny trial. 4 of them survive 2 months, 1 survives 3 months, 1 survives a year, and 3 survive 10 years.

While the median survival is 3 months, the *mean* survival is nearly 43 months; however, they can't know that at the end of the 4-year trial, because some of the participants are still alive at that point, so they stick with the median, which they do know (once half of the participants are gone).

I'm not saying the gap is usually that big, but when you hear that there's a "median" overall survival of 15.3 months, don't assume you have 15.3 more months to live. That's just not what the number means. It's a scientific convenience, not your personal destiny.

REPLY

Howdy North of...

Oh, I'm aware of that, thanks...but I find it interestingly scary to advertise that for people that don't have statistical education or training...LOL...no offense to anyone...but I can see how it would freak someone out!!!

I really DO thank you for the support...I meant that my 5 years of treatment has been a series of either no information or ...hmmm...BS...'sorry!...

I prefer to stay on top of things the best I can, read statistics but not necessarily believe them without finding myself in denial...Everybody is different in so many ways...physically, emotionally, psychologically...

Best regards

REPLY
Please sign in or register to post a reply.