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Pluvicto....now or later?
Well, time for another decision....I am stage4 met, on Orgovyx and Nubeqa for 6 months, PSA is 0.13 and T is 6 (as of July 15, probably lower now). Had 2nd pet scan May 28th, max SUV 24, down from 35 last October. So.....with the new FDA approval, being hormone sensitive, I could be a candidate. But.....at 6 cycles every 6 weeks that is a 9 month stretch of treatment. I have read that Pluvicto may extend OS by 4 months vs ADT/ARPI alone, not a good trade off in my opinion. OR....stay with the ADT/ARPI until it fails, then use Pluvicto? I am leaning towards waiting but if Pluvicto could destroy enough cancer cells now and I could get off the ADT, that sounds good to me. Any ideas or opinions? I have asked AI and it comes back 50/50....lol....who knew a computer could hedge its bets.
Thanks for reading my post, I will be reading yours!
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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.
Since you are considering doing it, you should get that genetic test to find out if it may not work at all.
Other reports have shown it to reduce PSA 50% or more in 60% of people and not effective in 40%. Since reading that though a doctor discussing Pluvicto at one of the conferences still used the 33% rule.
I know a guy who had it and a year later his PSA has finally risen to the level that he needs to do something about it. He got a full year with PSA below one. In his cases, he only had two sessions, So he can go back for more.
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1 ReactionThanks for the info Jeff, I was aware of the percentages (33%), have had a Foundation One test and have no mutations (yet) lol. The Dr has already told me I would need Pluvicto in the future, I am just trying to decide if earlier is better than later now that the guidelines have changed. The guy in your post...did he have two sessions of Pluvicto and then a year later have two more sessions? So he can have 2 more in another year? Then what?
If I were to take Pluvicto early it would be to reduce my cancer load enough to hopefully stop ADT and perhaps just continue Nubeqa. Otherwise I might just as well wait till the ADT/ARPI quits working then move on to the next treatment, Pluvicto or whatever new thing is offered. I dont have to decide right away, next appt is Sept 15, Ill know more then, new numbers! Cant wait!
Sure would be good to get off the ADT, maybe that is a false hope and not very realistic thinking on my part.
What do they say? "Hope springs eternal"...
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1 Reaction@stage4lovolmetpc
Howdy,
I'm one of the guys that decided to do the Pluvicto infusions. Of course, I passed the criteria. My stage IV, metastatic castration resistant cancer had been undetectable for about 1-1/2 years, but came back on a PET-PSMA scan, so now on Pluvicto.
I've had 3 infusions to date and it seems to be effective for me, 67% decrease in PSA after the 2nd second infusion and an additional 12% reduction after infusion #3. My goal is to do the 4th (September 2nd), wait the month to check PSA and, depending on that reading, get another PET-PSMA scan...
Starting at the 3rd infusion I suspended the ADT (Firmagon). The combination was overloading my body far too much. T went up a bit (54), but still low enough.
The Pluvicto side effects are not 'terribly bad'...extreme fatigue that, for me, has not gone away and super dry sinuses and mouth which causes me aggravation only because I'm a singer...I've had no bowel issues.
Like I've posted before...treatment becomes a "crap-shoot"...damned if you do or don't...but never let that keep you down! Keep your research and questions coming...we're all here to help.
Blessings as you proceed
'Sorry, "chemo brain"...the drop in PSA after the 3rd infusion was 22%, not 12%...
@stage4lovolmetpc
He’s still trying to decide whether or not he wants to do Pluvicto Or something else first.
He’s had prostate cancer for 12 years and has had almost every treatment available. He has Lynch syndrome, which makes it much more aggressive. If you attend, the reluctant brotherhood advanced prostate cancer meeting tonight you can talk to him. He runs the meeting..