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Docetaxel vs Pluvicto

Posted by cal77 @cal77, Feb 14 9:39am

Hi,
My husband's PSA is up to 400.
He's had one chemo of docetaxel, but only 1/3 dose because he's still recovering from spinal tumor at T4 which was removed mostly by surgery and radiation in November 2025.
Shouldn't the docetaxel work right away? It's a low dose, but still his PSA went up from 365 to 400 in 3 weeks...
The Dr. is going to give him 2 more treatments with docetaxel over the next 6 weeks, and has mentioned Pluvicto..
Does Pluvicto work? Is it as good as docetaxel? Does docetaxel always work for everyone? This is all so scarey...He was doing so well...Last October cycling 150K a week, mowing the lawn...
Any advice...? Obviously the cancer is spreading if his PSA is going up...Shouldn't they start Pluvicto now???

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jeff Marchi | @jeffmarc | Feb 14 11:23am

Docetaxel Doesn’t always work immediately. Frequently it takes two or three doses before results become positive. Seems your doctor is aware of this and that’s why he’s going to stop at three if Improvement isn’t realized. Chemo Is also very hard on the body, As the lower dose implies.

Pluvicto Is easier on the body than chemo. It is very effective in 1/3 of case cases works OK in 1/3 of cases and doesn’t work at all in 1/3 of cases.

It is a good idea to have a somatic genetic test Before doing Pluvicto. You probably also want an hereditary, genetic test. If he ends up having BRCA2 there is another drug that can be used, a PARP inhibitor.

If you have BRCA2 or ATM It seems to work better. If you have RB1, PTEN or TP53 They are Pluvicto resistant.

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cal77 | @cal77 | Feb 14 1:59pm

Thanks Jeff...
Good to know the docetaxel could still work.
They tested him for the BRCA2, but he didn't have it..
Fingers crossed and praying a lot that something will work.

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2 replies
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brianjarvis | @brianjarvis | Feb 14 4:52pm
In reply to @cal77 "Thanks Jeff... Good to know the docetaxel could still work. They tested him for the BRCA2,..." + (show)
Profile picture for cal77 @cal77

Thanks Jeff...
Good to know the docetaxel could still work.
They tested him for the BRCA2, but he didn't have it..
Fingers crossed and praying a lot that something will work.

Jump to this post

@cal77 Here’s an informative presentation about Pluvicto. Dr. Johnson (of Mayo Clinic) talks about scans in this presentation, starting with the scans we’ve all heard about (MRI, bone, & CT scans), and then going into detail about PSMA PET scans and Pluvicto:

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asolidrock | @asolidrock | Feb 14 6:07pm
In reply to @cal77 "Thanks Jeff... Good to know the docetaxel could still work. They tested him for the BRCA2,..." + (show)
Profile picture for cal77 @cal77

Thanks Jeff...
Good to know the docetaxel could still work.
They tested him for the BRCA2, but he didn't have it..
Fingers crossed and praying a lot that something will work.

Jump to this post

Praying for you. many options out there
Lots of support on here just to talk to someone helps; jeffmarc is a big encouragement and very knowledgeable.

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cal77 | @cal77 | Feb 15 10:59am
In reply to @brianjarvis "@cal77 Here’s an informative presentation about Pluvicto. Dr. Johnson (of Mayo Clinic) talks about scans in..." + (show)
Profile picture for brianjarvis @brianjarvis

@cal77 Here’s an informative presentation about Pluvicto. Dr. Johnson (of Mayo Clinic) talks about scans in this presentation, starting with the scans we’ve all heard about (MRI, bone, & CT scans), and then going into detail about PSMA PET scans and Pluvicto:

Jump to this post

@brianjarvis
Thanks , good video...
Fingers crossed..

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