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lutetium 177 treatment any experience


susan horn

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my husband is looking into this can anyone advise 

thank you 

susan horn

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Thank you for getting back 

has it helped with the bone mets psa and pain as my husband has 

mets all over and pain 

are you on any treatment now ?

any side affects from treatment 

Susan 

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Hi Susan, Results being obtained with Lutetium177 treatment are looking promising but everything is relative

It is difficult to comment constructively without knowing your husbands previous treatment history whether  treatment with Lutetium177 is something your husband should be considering.

I have been on the Lutetium177 trial conducted here in in Australia during last two years.I responded better to treatment better than some of the others on the trial.The results of the trial I have been on have not been published yet but from what I have been able to ascertain results from trials conducted elsewhere in the world are reasonably indicative of the results of the trial here.You may have already accessed these results elsewhere but for interest sake I shall include a rough summary of the sort of results that are indicative of what is being achieved with current Lu177 treatment.

PSA decreased in approximately 70 percent of patients treated
PSA decreased by > 50 percent in approximately 40 percent.
Approximately 70 percent of patients treated had PSA declines >50 percent that
were sustained for over 20 plus weeks;

The number and size of their metastases also decreased.
Hematotoxicity (from bone marrow suppression) was mild.
Xerostomia (dry mouth), nausea and fatigue in < 10 percent.
Excess radioactivity was cleared from the kidneys within 48 hours.

It is early days for (PPRT) Peptide Receptor Radionuclide Therapy. Not every patient is suitable for this treatment. In my case there was three days of testing involved before it was determined that I was a suitable candidate for treatment. One would have to carefully evaluate what other treatments maybe suitable before deciding upon Lu177.

Hope you find my comments of help.

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Hi Susan 

 

A lot of information about Lutetium has been posted already in these forums. You can access these previous posts by using the Search Box on the Forums page.

 

Lutetium is an experimental treatment which is generally only available through clinical trials .

 

As Curro points out, there are a limited number of oncologists who will provide Lutetium treatment outside clinical trials in exchange for a commercial payment. Whilst Curro quotes a cost of $10,000 per treatment, the figure mentioned to me is closer to $100,000 per treatment.

 

As Barrie mentions, not everyone is suitable for Lutetium treatment.  Some men do not have adequate PSMA expression. 

 

At present Lutetium treatment is not being used in the early stages of advanced prostate cancer.  At Peter MacCallum Cancer Centre in Melbourne, Lutetium is being  given to men with castrate resistant disease with widespread metastases who have exhausted most other treatments. 

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Hi Susan, Don't quite know what happened -you only got half a reply - I received your response before my reply had been read back and sent. Sorry about that.  Anyway, I shall now respond to your questions.

Other than continuing treatment with Zolodex (ADT) and Xgeva my last Lu177 treatment was July 2016. I had a total of 4 infusions.

According to a report in our local paper, some of the trial results obtained have been spectacular. "A Game Changer" -the examples quoted were in fact impressive.

My results, whilst better than many others on trial have been good but not spectacular. Mets in the bones have significantly reduced in number and size, but I still have a number that have not responded. Most visceral or soft tumor mets have disappeared altogether. PSA has dropped from the mid 80's down to 8. Pain management is still something to be resolved-treatment with Lu177 in itself has not impacted greatly on pain level. I am still seeking to control pain with a mixture of pain killers. A way to go yet. Last change to pain medication only occurred 4 days ago.

Main side effect of treatment was and still is dry mouth (Xerostomia). Fatigue level has not changed much either - but when on Zolodex, fatigue is a common and persistent problem. From my point of view, overall the other minor side effects are small and of no consequence compared to the benefit obtained from treatment.

Trials are at a standstill in Australia at present- but a larger blind placebo trial is planned for later this year. 

I understand trials are starting or are now underway in the USA. If you need further info just let me know.

Cheers

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HI, People might be interested to know that this treatment is now offered in Sydney at Macquarie University Hospital or Macquarie Medical Imaging. Dr Lenzo. I think that it is also now offered in Melbourne.

I am having the treatment this coming Friday. The major drawback is cost. It is just less than $10,000 and there is no PBS.

Cheers Brian

 

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  • 7 months later...

hi, my husband is considering the treatment. His oncologist has sent the referral to Sydney. Would you tell me if they conducted the interwiew by skype( we are in melbourne) in a professional manner? I'm having some concerns as not all of the mets are PSMA avid from what we understand on the PSMA pet scan the major tumors are not PSMA active. Thank you for your help

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Hi Claude

As a thought - what about you ask your husbands Oncologist to give you a referral to the principle investigator in this trial :-

A/Professor Michael Hofman at the VCCC in Melbourne.

If the major tumors are not PSMA active - it is improbable that Lutetium177 treatment will work for your husband but A/Professor Michael Hofman is one of the top experts on this treatment in Australia - he is the person who set up the Lutetium trial in the first place. If he feels there is insufficient expression of PSMA he might be able to guide you as to what other treatments you can consider.

I've had Lutetium treatment and always happy to take a phone call to discuss.

 

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  • 5 months later...

Hi 

my husband is considering a trial in New York with Lu-PSMA 

wondering how everyone who has tried this is doing a year later and if you can repeat the dose 

there are two trials one just gives one large dose I think 8

and the other is a trial that is opening soon 

thank you 

Susan Horn 

wondering of it helps with bone Mets and pain 

 

 

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Guest Claude

My husband had 2 infusions with no results at all. The PSA went from 85 to 200 after the 1st one . We were told it is a flare up ( PSA climbing because the cancer cells died) then  to 400 after the 2sd infusion, , the bone scan showing an increase activity of the Mets, the traitment was stopped. He is now on Xtandy and the P.sa had gone down to 373 new blood test in about 2 weeks. Pain wise the traitment did very little for my husband 

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