Can anyone share their experience with Pluvicto?

Posted by vcash @vcash, Apr 22, 2024

My 85 year old dad has prostate cancer that has metastasized to his bones. Zytiga is no longer effective. He is considering Pluvicto. I would appreciate input from those who have used Pluvicto.

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I have had two injections of Pluvicto
And have some side effects, dry mouth, fatigue, and some GI problems but nothing serious
My PSA would not go down until I started Pluvicto
My PSA went from 20 to 1.1 and five weeks treatments are every six weeks

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I was diagnosed stage 3 metastatic prostate cancer in 2014. Had all the typical surgeries, chemo, drugs, orchiectomy, targeted beam radiation, etc. Those treatments kicked the can down the road for a few years, but entered stage 4 in 2020. I became a clinical trial patient in 2021 for Norvartis Pharmaceutical's Pluvicto at U. of Chicago Medical Center, ending in spring 2022 with remarkable results.
The cancer had a slight uptick in late 2024 and (through very, very special arrangements) I started another 6 rounds of Pluvicto at that time. Again, it is working remarkably well. I paused after 4 of the (2nd) 6 treatments to save the remaining 2 later, if needed. Side effects were extremely minimal, experiencing some late treatment fatigue and the obvious temporary radiation for 3 or so days after each treatment, but no nausea.
As of today, 2/19/26, my PSA is still below 0.008 and other indicators, i.e. tumors, bloodwork, etc. are very good. I remain a very active 74 year old and live a normal lifestyle.
Thus, for me, I was at the right time, right place, right connections and believe it was the wisest decision I could have made. I have nothing but encouragement.
Stay in touch.

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Hey im just about to start pluvecto. Im 56years old and was wanting to hear how long people have been on pluvecto. im kinda scared how much extra time this treatment might give me, not ready to go yet, so if anyone has some encoraging Pluvecto stories please respond.

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Profile picture for smc24 @smc24

Based on my experience after receiving my 10th of 12 treatments (yes, that two rounds over 4 years), the first 6 being the original clinical trial, here are my comments.
I get a little bit of radiation sickness the day after with milder symptoms the following few days. A mild headache, upset stomach and a little fatigue. Mostly annoying. A very mild diet of mostly chicken noodle soup and mashed potatoes is my comfort food. I take pepsid (not Pepsi) to reduce stomach acid starting the day before and as needed for several days after each treatment. And, I keep Tums and some antinausea tables (left over from my chemo) nearby to settle that jumpy stomach. It really hasn't been too bad at all.
The Pluvicto literature describes the radiation precautions based on it's half life of about 6-7 days. It's 3 days of not sleeping beside or spending hours within a few feet of someone including pets, babies, pregnant women, etc. But, you can be in the same room while staying a reasonable distance apart. The radiation is expelled mostly through body fluid; urine, saliva, sweat, exhaling vapor, etc. I store and wash my close separately for a week or so, don't share food, towels, etc. I carry a pocket size geiger counter (from my clinical trial days) and can see exactly how quickly the radiation value declines, comparing them to published charts. In 4 or 5 days, I return to a normal life being a little cautious. Drink lots of fluids to flush it out of your bladder and colon. You don't want that radiation hanging around there too long.
I could go on, but in reality, FOR ME, it's not a big deal. Listen to to radiation specialists and use common sense. The more you educate yourself, the easier and less fearful it will be. Just do it.

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@smc24
i am just about to start pluvecto. How long have you been on it. i'm wondering how much time it might buy me. Kinda scared. was diagnosed 0ct2024 looking to keep myself in this world as long as i can only 56.

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Profile picture for oldfords @oldfords

I started this journey 2 years ago and have had 6 rounds of chemo and have been on nebqua and lupron for this time. Now it seems it quit working so I am now taking once a day orgovyx, nubqua, and am going to start pluvicto next week. I know what chemo was like for a few days after a treatment, but wonder what to expect with an infusion of pluvicto every 6 weeks. Anyone had this treatment, and what to ecpect?

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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.

Here is a very long discussion from many people about their experience with Pluvicto
https://connect.mayoclinic.org/discussion/can-anyone-share-their-experience-with-pluvicto/

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I started this journey 2 years ago and have had 6 rounds of chemo and have been on nebqua and lupron for this time. Now it seems it quit working so I am now taking once a day orgovyx, nubqua, and am going to start pluvicto next week. I know what chemo was like for a few days after a treatment, but wonder what to expect with an infusion of pluvicto every 6 weeks. Anyone had this treatment, and what to ecpect?

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I have just had my third Pluvicto infusion and have had no problems other than fatigue and some constipation. However, I have developed something else which I don't whether is connected to the treatment or not. My wife and I usually like to have wine with dinner. Prior to the Pluvicto, I had no problems with this. Recently though, I have found that after my usual two glasses, I feel extremely dizzy and sick if I stand up (if I remain seated, there is no problem). I tried cutting back to one glass and, although not as bad, the effect remains. Has anyone else had this happen?

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Profile picture for shawnswife @shawnswife

@gtgitha
Greetings. I, also, am the wife of a pig-headed man. He was diagnosed Grade 5, Gleason score of 9 last December, with 5 initial mets sites to bones. He takes Nubeqa BID and gets injections of Lupron every 3 months. He did chemo (Taxotere, ending in May), and radiation on the prostate with concentrated radiation to 2 new bone sites - that grew during chemotherapy - in September. Good results from radiation overall, but 2 new sites popped up; next scan in April - at which time Pluvicto is the choice, if there are additional sites. That is why I am beginning earnest research now. I am a retired ER nurse as well, and very much appreciate your post!
Hope you are well and wishing you peace - Mary

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@shawnswife, I'm tagging @lag to bring her into this discussion with you Mary. Her husband was treated with Pluvicto and she may have some tips to share.

Do you have specific questions?

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Profile picture for shawnswife @shawnswife

@gtgitha
Greetings. I, also, am the wife of a pig-headed man. He was diagnosed Grade 5, Gleason score of 9 last December, with 5 initial mets sites to bones. He takes Nubeqa BID and gets injections of Lupron every 3 months. He did chemo (Taxotere, ending in May), and radiation on the prostate with concentrated radiation to 2 new bone sites - that grew during chemotherapy - in September. Good results from radiation overall, but 2 new sites popped up; next scan in April - at which time Pluvicto is the choice, if there are additional sites. That is why I am beginning earnest research now. I am a retired ER nurse as well, and very much appreciate your post!
Hope you are well and wishing you peace - Mary

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@shawnswife
Is there some reason they haven’t used SBRT radiation to zap those two new Mets that came up?

Usually, you will go to Pluvicto if you have multiple mets besides those two that you mentioned. You do say if there are additional sites, did chemo not eliminate all that were there?

A lot of doctors think that just zapping them as they come up is the best treatment.

We’re all hoping for the Best for your husband. Nice to have a wife who is a nurse too be the caregiver.

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Profile picture for redroadtraveler @redroadtraveler

I am 80 years old with stage IV prostate cancer which has metasasized throughout my bones. Been on various immunotherapy treatments for 3-4 years (most recent being Keytruda). All of them have run their course and are no longer effective.

I tried for several months to get the Pluvicto treatment but they didn't do it due to the FDA saying a person had to have had chemotherapy first. I elected to NOT have chemotherapy as it made no sense to me to kill off everything and hope that the good comes back faster than the bad.

Very recently, the manufacturer began to question the necessity for chemotherapy prior to Pluvicto and I am one of the first people to get Pluvicto without having had chemotherapy.

Pluvicto treatment protocol is an IV injection every six weeks for a total of six times. It is a heavy duty radiation treatment but it is NOT chemotherapy. It targets the cancer cells instead of the shotgun approach of chemotherapy.

I am halfway through my Pluvicto treatment. I have had three injections and will get number four in a week.

You will get detailed scans prior to the treatment, and the doctor will monitor your blood work closely and see how you are tolerating treatment before giving you the next injection.

After the injection, they turn you loose when your radiation level is three at a distance of three feet.

We joke that I "glow in the dark" after the injection but there is a certain amount of truth in that. I wanted this treatment for myself, but was concerned about "collateral damage" of radiation to anyone else around me. The official guidelines tell you to maintain a three foot distance from everyone for three days, and for seven days from pregnant women and small children (and by extension small animals like cats or dogs).

Every radioactive substance has a half-life and decays over time. I purchased a dosimeter (Geiger counter) from Amazon for about $100 to monitor my actual condition rather than simply going by their guidelines.

My personal experience is that, for me, the guidelines are not strict enough. I do not want to cause collateral radiation damage to anyone else, so monitor my radiation level daily at three feet, one and a half feet, and right next to my skin.

My personal protocol is to isolate myself for one week. I am alone in the bedroom, reading, binge watching Netflix, etc., leaving only briefly to get something to eat or go to the bathroom.

During week two I loosen up a bit, allowing brief contact such as a hug or a handshake, but no prolonged contact.

By the end of two weeks from my injection, my personal radiation level is down to zero at my skin, so I no longer have any danger of giving collateral radiation damage to anyone. At that point I resume sleeping in the same bed with my wife and have no issues with personal contact with others.

Everyone reacts differently to different treatments. I have tolerated it reasonably well. The worst side effect has been serious constipation. Also a moderate increase in fatigue.

I would like to get another scan now, halfway through treatment, but insurance won't pay for it. I will get another scan when all treatments are done so I will at least have a before and after reading on how effective (or ineffective) it has been.

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@redroadtraveler
Hello Redroad! I've just joined the group, and am hoping that you are still fighting the fight.
I am a retired ER nurse and I just want to let you know how dead-on informative your post was!
My husband was diagnosed last December, is on hormone therapy, and has been through chemo and radiation. Next scan is in April, and we may be looking at Pluvitco at that time.
I had not even thought about our cats - thank you for that! Your post was so thorough, you must have been an engineer!

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