Ra223 use for Pca in bones

[Patrick Turner]

Hi all, there has been a conference in Basel in Switzerland discussing Pca.

A summary of opinions is at https://www.urotoday.com/conference-highlights/apccc-2019.html

 

I found the following info by a Dr Sartor at 

https://www.urotoday.com/conference-highlights/apccc-2019/114675-apccc-2019-radium-223-and-bone-health-agents-lessons-learned.html

This makes sobering reading because Ra223 seems to cause more fractures away from sites with bone mets/fractures in bones but the "take home" message from Dr Sartor says that denosumab or zelodronic acid should be given before Ra223, and during its administration.

 

Taking abiraterone while having Ra223 admin much increases bone fracture risk. 

 

I have wondered what effect Ra223 might have on areas of bone with arthritis and have not found an answer.

 

I have not yet read about what the conference may have said about Lu177 or Ac225, but methinks where it is possible these two nuclides may be more effective and safer than Ra223 where a PsMa Ga68 scan shows that the mets have PsMa avidity.

 

Meanwhile, I see no future benefit yet to have Ra223. I do seem to be getting a benefit following 4 x Lu177 shots after Nov 2018. 

Lu177 and general health has made it possible to cycle the 19km to and from home to Canberra Hospital to have a follow up chat with my oncologist. 

Regards to all, Patrick Turner. 

 

[Rozi]

Thanks Patrick.... that's interesting to me... my husband has just had his 3rd Lutetium infusion and it seems to be working quite well.....  he's clinically better, put back the weight he lost, less pain, less fatigue, scans look marginally better... the only issue is that his PSA is bouncing around...… fingers crossed that's not a bad omen …… cheers

[ardee]

FWIW, personally I feel Rad 225/Xofigo is old technology and would not navigate anyone in that direction with PSMA sensitized treatment available .... if I were Bayer I would be making as much hay as I could while the sun still shines. Once Lu177 is officially approved, they are DOA.

 

On another, totally different topic .... I was in the UK for the 3rd Test, and as much as I think Stoakes is a yob, that innings was spectacular. A young friend of mine got 7-1 on an England victory before their last innings. Looks fairly even after the 1st Day of this one .....

[Patrick Turner]

1 hour ago, ardee said:

Once Lu177 is officially approved, they are DOA.

Well, getting full approval for Lu177 or Ac225 plus getting PBS funding with Medicare would create a huge wave of blokes to crash on the shores of atomic medicine providers.

Right now, we are allowed to have Lu177 without full approval if chemo fails. Alternatives to Lu177 could be :- 

1. Marrow transplant using in-vitro cultured marrow cells from Germaine Greer. Side effect is make nice old men turn into grumpie old shielas. 

2. IV infusions of ground up cane toad venom. Side effects, loud croaking at night, upsetting the missus, leaping like a frog into ponds when on an afternoon at the park with grand kiddies.

3. IV infusions of altered Round Up to suit genetic make up of Pca mets. Side effects include making fresh bowls of salad leap out the back door to avoid nourishing you. 

But on a more positive note, got to oncologist today, and latest Psa is 0.41, so its continuing down and down. My somewhat serious onco was happy to see this and keep me on enzalutamide, and see me in lycra again.

He admitted he bought a bicycle and rode it a short distance, and said his arse felt very sore and lots of leg muscles, and I said it takes times to get used to a bicycle saddle and get muscles used to doing more than corridor walks in hospitals and moving a chair to sit down on. But over time, an amazing affinity with a bicycle is possible. 

I've lost track of the Cricket tests, but was sad to see Ms Barty eliminated in her latest bid for a tennis win. Meanwhile Laver said Krigios needs to get some discipline.....

I'll do a few more km next Satdy, then have a good massage of muscles et all around right sore hip area on Sundi.

Doc said it probably is not the joint, its a problem with muscles and a tendon. 

If I can be better, I should welcome it to happen,

Patrick Turner. 

[Barree]

Xofigo Radium223 - Behind-the-scene.

 

For a number of years now your committee has been involved in continued and ongoing discussions with Bayer Australia P/L and the PBAC in an attempt to resolve the various issues associated with listing Xofigo^R Radium223 on the PBS.

 

On two previous occasions Bayer have advised us that they have no intention of applying to list their product on the PBS, but we are a persistent group and have once again approached them and asked if they will reconsider their position and give further consideration to applying for listing of their product on the PBS.

 

Regrettably, Bayer appear to be totally disinterested in the Australian market and on this occasion like the last two occasions they have advised your committee that Xofigo is approved by the (TGA) Therapeutic Goods Association for use in Australia and is available through your oncologist at the scheduled price and they will definitely not be applying to have it listed on the PBS.

 

Your committee will continue to do what they can to persuade Bayer to make their unique radiopharmaceutical available at an affordable price for Australian patients but it seems to us now that no matter what we do, it’s extremely unlikely that you will be able to get Xofigo at a concession price in the foreseeable future.

Barree