What is the recommended treatment after 6 Pluvicto doses?

I was just diagnosed with metastic PC in January. I'm on Abiraterone daily and my PSA dropped from 359 to 69 in 3 weeks. I got a Lupron shot 2 weeks ago. Waiting for my next PSA test to see how I'm doing. Pluvicto was something I read about in my panic to gather info. Did you good through similar treatments as I did before starting Pluvicto? How long ago were you diagnosed? How often do you get the Pluvicto?

I was dx'd over 10 years ago. I have been on a variety of medications plus clinical trials. The medications do help, but only for a while. So then you begin a different medication. I also participated in clinical trials which were of no help. Then I began chemo...it was somewhat helpful. Now I am about to have my fifth dose of Pluvicto. It's too early to know how effective it is at this time.

This info is very helpful and it gives me hope. Thank you for the details. I know there odds. I am hopeful that new treatments continue to be developed that will help us all.

@donalan, I'm tagging fellow members like @leebeth @suwairi @patgwenn @ncoic @bburgess1 @royalbee @bamaples @bamaples @dlylecpa @robert570 who have experience with Pluvicto (Lu 177) and have shared in this related discussion:
– Anyone on Pluvicto (Lu 177), a new drug for prostate cancer? https://connect.mayoclinic.org/discussion/any-one-on-pluvecto-a-relatively-new-drug/

You ask a great question. After 6 doses of Pluvicto, what next for maintenance treatment? Some members have just started Pluvicto while others have had several doses or completed it. I hope you'll share what your oncologists have suggested.

Donalan, back to you. What has been recommended for you next?

Going on 8 years Advanced pCA. Exhausted all other options, Hormone therapy and Docetaxel / Cabazitaxel Chemo. Making arrangements to get Pluvicto as it just got to my small city. I will be the first locally to get it. Not sure if I want to delay or not as the precautions for the radioactivity are pretty serious for 1 week. Basically isolation. I feel pretty well with not much pain. lower back occasionally hurts but walking around helps.

I was lucky to get a research professor at the Huntsman Cancer Institute in Salt Lake City for my first doctor. He put me on a Hormone therapy clinical trial with TAK 700. It worked for almost 4 years.

He conducted the Talapro-2 study of a combination of 2 drugs. At first it was just for people who had a defective prostate repair gene, but now he has seen some benefit in all levels of pCA. This may be the next step for me after Pluvicto or if I delay Pluvicto. Check out the Talapro-2 study.

Starting Pluvicto on Sept 26th. Asked my Oncologist what's after that? He said Pluvicto is currently the last line of BSoC. (Best Standard of Care)

After that, he would consider Cabazitaxel again (which has already failed by itself) with adding Carboplatin.

Then there is the Talapro-2 study drug combo (My experimental oncologist is Dr. Neeraj Agarwal at Huntsman Cancer Institute in SLC UT, who co-directed the Talapro-2 study. (I'm so lucky to have direct access to a solid tumor research professor!) The Talapro-2 study is a combination of drugs that best target advanced Prostate Cancer that has defective BRCA repair genes. I DO NOT have the genetic defect this is directed at, but they are seeing some benefit in people without the defective repair genes, although not nearly as pronounced as those with the defective gene.

After that, any Clinical Trials that I may qualify for according to my primary oncologist are all that's left before Hospice care. Looks like the toolbox is getting low.

How was side effects I have pluvicto in my future thanks

I recently read an article in the Harvard medical school report on P C regarding the use of enzalutamide and a new drug, talazoparib, and this has been given after the use of chemo and perhaps after or before Pluvicto. It is also given for breast and ovarian cancer. It may be something to chat with your oncologist about. Pluvicto and talazoparib may be drugs in my future. I am 1 year post RP and I had 13 months of ADT and Erleada. I am Gleason 9 aggressive advanced CRPC. Presently, my cancer is sleeping but who knows how long that will be the case. Good luck to us all.

Yep, That's the Talapro-2 study I mentioned, co-directed by Dr. N. Agarwal at Huntsman Cancer Institute. I almost got on the clinical trial for that but I lived just a bit too far from SLC, UT to make it for the required periodic / random blood draws required for the monitoring.

Have you tried zovigo