What you’ll find in the data is that PSA levels can go up during Pluvicto treatment. Fluctuations and temporary spikes in PSA are quite common, especially during the first few cycles of therapy.

A temporary spike in PSA that occurs shortly after the first or second injection can happen. As the targeted radiation from Pluvicto successfully damages and kills the cancer cells, those dying cells rupture. This massive cellular breakdown releases a wave of stored PSA directly into the bloodstream.

This type of spike is actually a sign that the treatment is actively destroying the tumors.

If it were me, I would go for that 2nd (& 3, 4, 5,& 6) treatments.

If Pluvicto doesn’t work, you move on to next steps. (Was he PSMA-positive?)