LU-177 - My Next Treatment

Doc said yes to future Lu-177 treatments. Not sure if insurance would say yes, but I’d spend the money if not. Thanks.

Steve55777's posts here ~~~ detailing his treatment S-U-C-C-E-S-S with Lutetium-177 ~~~ have been tremendous.

Even better, his doctors have stated that additional treatments are certainly possible, down the road, if needed.

I found this brief description in a recent newsletter sent to me by the Prostate Cancer Foundation.

I especially focused on the detailed description of how prostate cancer cells are TARGETED and literally KILLED. Yes, targeted & killed!

I felt it helped me better understand these new treatments:

"TITLE: Breaking NEWS --- First-In-Class Therapy Approved For Advanced Prostate Cancer:

Lutetium- PSMA - 617 (LU- PSMA) is now FDA-approved for metastatic castrate-resistant prostate cancer patients who have received certain other treatments (androgen receptor pathway targeting agents & taxane-based chemotherapy).

Patients must also have a positive PSMA PET scan.

This represents a PARADIGM SHIFT in the treatment of advanced prostate cancer, and is HOPEFUL news for patients who have seen their disease progress, on other therapies.

LU-PSMA works to deliver a small amount of RADIATION to prostate cancer cells, anywhere in the body.

One part of the LU-PSMA molecule RECOGNIZES & BINDS to its target, called PSMA (prostate-cancer specific antigen).

PSMA is a protein that is present on nearly all prostate cancer cells, but NOT on most normal tissue.

This PSMA-seeking 'arrow' is chemically linked to a radioactive 'PAYLOAD' called LUTETIUM-177.

When LU-PSMA binds to the prostate cancer cells, the cell takes up the radioactive drug and is KILLED.

The radiation from LUTETIUM-177 travels only a short distance outside the target cell, so the surrounding normal tissue is largely spared."

My best to each & all ~~~
CYCLONE - # Iowa State University

Post Edited (Cyclone-ISU) : 5/19/2022 10:41:15 AM (GMT-6)

ADT represents a totally different approach to prostate cancer control, and I doubt that it will be replaced by PSMA directed therapies.
Moreover, I believe that the current FDA guideline for Lu-177-PSMA-617 indicates that (in the USA) this therapy can only be used in castrate-resistant patients. In other words, in patients where ADT has failed.
I hope though that trials will be conducted for other patient groups. Or perhaps they already are ongoing. Experiences gained in other countries (Germany, India, Australia etc.) may be relevant as of today; I haven't' looked that far.

Wonderful news Steve. Gives us all hope:

Hello, Steve55777 ~~~

Tremendous, beyond words!

Last August 2021, your PSA was about 65.0 and now it has crept down into decimals!

What's even more encouraging, the LU-177 treatments seem to still be paying beneficial DIVIDENDS!

I'm just VERY thankful to read your latest post!

Truly --- no better news than this! Best news of the day!

Handshake, fellowship, & my very best ~~~

CYCLONE - # Iowa State University

Sparky: Your doctors at MDA may be better informed, but it appears that Novartis has temporarily halted supplying the agent:
https://www.novartis.com/news/media-releases/novartis-provides-update-production-radioligand-therapy-medicines
I highly recommend that you look into Pylarify as well:
https://www.pylarify.com/?gclid=eaiaiqobchmiqzoarvs8-aivh7rich3y-agieaayasaaegjowpd_bwe

Sr Sailor said...
Sparky: Your doctors at MDA may be better informed, but it appears that Novartis has temporarily halted supplying the agent:
https://www.novartis.com/news/media-releases/novartis-provides-update-production-radioligand-therapy-medicines
I highly recommend that you look into Pylarify as well:
https://www.pylarify.com/?gclid=eaiaiqobchmiqzoarvs8-aivh7rich3y-agieaayasaaegjowpd_bwe

Thank you Sr. Sailor. I'll check that out.

Update - The PSA drop continues. Down nearly 10% from 0.71 to 0.64.(Down from 65 last August before treatment #1.)
My Doc says he has another patient who remain undetectable--a year after LU-177.
THAT'S showing us what is possible!
Blessings, brothers. -Steve

I find out this week if I get into a trial also. I am castrate resistant and have 4 spots on my spine which sucks. I’ve had radiation twice, first to the prostate bed and second time to lymph nodes. Been on ADT and testosterone is >2.5 but Nubeqa didn’t work.

If I get in the trial I will get either Zytiga, which they were going to do next anyways, or the LU -177 injection. I’ve kept up on your story Steve5577 and it gives me hope. The trial is to determine if using these two tools before chemo is helpful. My PSA was 3.06 about 3 weeks ago so Dr said I’m too early for chemo anyway.

I’ve read good things about both. At first I thought I wanted the LU-177 but after reading the Zytiga thread on here both look like good options. We wait & worry as they took me off of Nubeqa @ 3 weeks ago and I’ve been on nothing since then.

Hello, Steve55777 ~

Have followed all your updates since the "get-go" & I am so thankful to see your latest lab results.

You have no idea how thrilled I am for you. I'm cheering!

I KNOW what good news like this can mean to a fellow. It's s-o-o-o-o encouraging! Your latest news is like an early Christmas present!

Your treatments ~ with LUTETIUM-177 ~ have had a jaw-dropping & astounding impact on your PSA scores.

Your treatments instill hope for many readers here ~ and I believe these treatments represent a huge leap forward.

I was also enthused when you shared another round of these treatments would be possible ~ down the road ~ if needed.

Even after your last treatment, your PSA is still declining. That is ALSO encouraging!

Thankful, beyond words, to read your latest update, Steve55777!

Handshake, best wishes, & fellowship ~

CYCLONE ~ # Iowa State University

Olmanhunk said...
I’m curious if they give you anything after the last injection. Do you still get Zytiga to keep it from coming back since HT doesn’t work for me

Olmanhunk,
I can't say for certain, but I think a patient would stay on ADT during and after LU-177 treatment because even though some cancer cells have become ADT resistant, there are plenty of cancer cells that the ADT is still holding down.

Yes, I’m still on ADT via orgovyx. That was, as Mattam thought, continued during and after LU-177. The thought is that while I’m deemed castrate resistant there may be SOME pc that’s not. So my guess is I’ll just stay on that as a precaution. Best of luck with the trial. If given the choice between Zytiga and LU 177, I’d go with LU 177.

The radioactive part is mostly this:
1. Most will be exiting your body via urine. So use your own bathroom for 3 days. Wipe yourself off after you go. Close lid. Flush twice.
2. Sleep alone 3 days for precaution. You can be near others, just no long hugs.
3. Drink lots of water to get radiation out faster through urine. Change underwear if you think you dripped anything.

Your docs will give you all the post treatment instruction to follow. Just follow those and you’ll be fine.

I did early morning treatments and was tired after lunch. Slept well after dinner. Took it easy day after but otherwise no symptoms. Read back through this post for more details. Congratulations on getting into the trial! Best of luck.