Can anyone share their experience with Pluvicto?

Pluvicto was started as my PSA abruptly increased from a low of 8 after doxetaxel treatment to 17 a few months later. By the time Pluvicto was started the PSA was 198.
After the first infusion, the PSA dropped to 100. After the second infusion, up again to 120. After the third infusion, the PSA was 364 - obviously a treatment failure. Options now are essentially nonexistent. I am unwilling to accept the debilitating side effects of a repeat doxetaxel ( or other chemo agent) for minimal short term benefit.

Did it work What is PSA What is status of PC metaseries Bone?

Thank you for this information. My husband is on Medicare and 6 treatments are what they have approved. I have not heard of any private insurance companies that would cover more treatments.

Here is my personal situation. I was a clinical trial patient for Norvartis Pharmaceutical in 2021-22 for what became Pluvicto. No insurance was involved. 2 years later, the prostate cancer has returned and I am going through the same 6 Pluvicto treatments again, but this time Medicare and my private insurance in paying. My oncology group worked with and obtained approval from the insurance providers.
So, I'm assuming insurance would NOT pay for the treatments twice (6+6=12). I have heard of, but do not know of anyone personally, except myself repeating the treatments.
Six teatments are about $300,000 plus peripheral costs of maybe $25,000-50,000.

Haven't gotten to the question yet of if it is advisable to start on a second round of Pluvicto what the insurance situation is.

The FDA has only authorized six infusions of Pluvicto for the United States. Other countries permit additional rounds. And some few oncologists in the US are giving another round of six under a rubric that is unclear; maybe a clinical trial or some emergency authorization they can get? The Kwon team at Mayo Rochester just told us they are not giving more than one round of six. As for Medicare or private insurance, I have no idea how the extra round is paid for.

Ii is my understanding that Medicare covers only 6 rounds of Pluvicto. I am just curious..is there private insurance that covers more?

My experience was fairly similar to Lags husband.

Went through all six treatments, then got a psma pet scan to check on results.

A couple of years ago I had a five session targeted radiation treatment. The psma pet scan showed one new cancerous spot coming just off the edge of one of the previous targeted radiation treatment spots (not related to the Pluvicto treatment).

Other then that, the psma pet scan showed the larger cancerous areas diminished by about half, the smaller areas of cancer gone, and no other new growth areas.

I am currently undergoing another series of five targeted radiation treatments for the one area which has appeared just off the old area that was previously treated with targeted radiation.

As far as PSA is concerned I have had eligard shots to keep my testosterone low. The theory is low testosterone results in low cancer growth, but I not found that to be true. All the eligard seems to do for me is keep my testosterone down. I see no effect one way or the other on my cancer. My testosterone is currently high, in the seventies, but I don't take that as a reliable market of imminent cancer doom.

I will have to see how I am in a few weeks after my current series of five targeted radiation treatments have run their course and settled in to determine what comes next. I know others who have successfully handled the Pluvicto treatment have now started on a second set of six rounds of Pluvicto. I am very open to going that route, but also want to see what, if anything else, allopathic medicine may have to offer.

I know you asked redroadtraveler, but I thought I would answer your questions by saying what my husband's recent experience with Pluvicto was. As he said, every man's experience is different, so keep that in mind as different people answer you. My husband had Pluvicto treatment at Mayo Rochester from January 2024 through August 2024. In September 2024 he had a Choline C-11 PET scan and lab work to determine how successful the treatment had been. (Dr. Kwon's protocol is to get a PSMA PET scan near the end of Pluvicto treatment and then a C-11 PET scan after treatment has concluded, because the scans look for different types of cancer cells.) The September C-11 PET showed the targeted metastases to be faded and likely destroyed by the Pluvicto, and also showed no new Choline-avid metastases. This was good news. However, my husband was disappointed that his PSA did not become undetectable as a result of the Pluvicto infusions. The nuclear medicine and urology teams both said he nonetheless had a very positive result of the treatment. The Kwon team has scheduled him for a PSMA PET and abdominal/pelvic MRI on January 6 to see if any new metastases have appeared by then as a result of cancer hiding in his body. As they always say, "we can't treat what we can't see." Keep in mind that other men who post here about their Pluvicto experiences may have had better or less good outcomes. There are no guarantees, but it is now standard of care for some men who are Stage 4 and have progressed on other treatments.

What was your response to Pluvicto? What was your PSA at the start of treatment? Did you get back to undetectable? Did the bone metastases shrink or resolve? Anything you are willing to share would be most helpful.