Anyone on Pluvicto (Lu 177), a new drug for prostate cancer?

Have you discussed a flare phenomenon with your oncologist?

Welcome @suwairi. Rising PSA can mean a number of different things.

You may wish to read these related discussions:
– Post prostatectomy: What do rising PSA levels mean? https://connect.mayoclinic.org/discussion/post-prostatectomy/
– PSA numbers: Questions about new treatments https://connect.mayoclinic.org/discussion/psa-numbers/

There are several reasons why one's PSA level may rise after being stable for a time. This article explains it well:
– PSA levels after prostatectomy https://www.medicalnewstoday.com/articles/323899.php

Here's an excerpt from the article:
"Seeing a rise in PSA level does not always mean that prostate cancer is returning or spreading. The test is very sensitive and can pick up small changes in PSA levels. Doctors will usually want to know how quickly levels of PSA in the blood are rising. To find this out, a person will need to have regular PSA tests. If levels of PSA remain stable or rise very slowly, treatment may not be necessary.

In some cases, high PSA levels in the blood are not due to cancer cells. Some factors that can affect PSA levels include:
– older age
– ethnicity
– medication
A doctor will take these factors and the person's medical history into account when looking at test results. This can help them decide if PSA levels are high enough to cause concern."

The PSA test alone is not enough to determine cause or next steps. I agree with @rso that it is time to discuss the treatment and the changes in your PSA with your oncologist. When is your next appointment with your oncologist?

This flare phenomenon has not yet been discussed with the treating physician. But what does this phenomenon mean?

After two weeks.

I believe it's just a rise after treatment. I experienced it during my docetaxal treatment. I found this article regarding flare phenomenon as I was researching Pluvitco. https://link.springer.com/article/10.1007/s00259-022-05910-w
I am not an expert, mind you, but rather like you , dealing with mcrpc and am still waiting to schedule Pluvitco. I hope this helps you. Much luck to you.

Darolutimide has been approved for metastatic castrate sensitive PC google it

On August 5, 2022, the Food and Drug Administration approved darolutamide (Nubeqa, Bayer HealthCare Pharmaceuticals Inc.) tablets in combination with docetaxel for adult patients with metastatic hormone-sensitive prostate cancer (mHSPC).

Efficacy was based on ARASENS (NCT02799602), a randomized, multicenter, double-blind, placebo-controlled clinical trial in 1306 patients with mHSPC. Patients were randomized to receive either darolutamide 600 mg orally twice daily plus docetaxel 75 mg/m2 intravenously administered every 3 weeks for up to 6 cycles or docetaxel plus placebo. All patients received a gonadotropin-releasing hormone analog concurrently or had a bilateral orchiectomy.

On August 5, 2022, the Food and Drug Administration approved darolutamide (Nubeqa, Bayer HealthCare Pharmaceuticals Inc.) tablets in combination with docetaxel for adult patients with metastatic hormone-sensitive prostate cancer (mHSPC).

Thanks, I saw that. I appreciate the reminder. I understand darolutimide is very similar to enzalutimide which I have used. We are keeping an eye on the new and developing drugs. Science is amazing. It gives me considerable hope.

My first gene mutation results showed that I do not respond to any of the newer immunotherapy drugs. I wish I had known that before being on abiraterone for 8 months. Waiting now for my second results from a recent prostate biopsy to see if any other mutations are present while I wait for Pluvitco. All we can do is remain hopeful and definitely place our faith in the research being performed. Science is definitely amazing.