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Encore: NEW TRIAL LUTETIUM / OLAPARIB   JUST ANNOUNCED - NOW RECRUTING AT PETER MAC


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Barree posted details of the new trial as a comment on his earlier posting on upcoming Lutetium trials.

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Patrick Turner

Hi Barree,

All that Peter Mac is doing seems just great, and if the Olaparib addition supercharges the Pca killing effect of Lu177, then its a big benefit to more men.

Of course if this trail results in standard Lu177 therapy becoming more expensive, then I guess the present price of what Theranostics Australia would rise, but this means less men can afford it. If only 1% of the $2.8trillion in superfunds could be directed to public health costs, many more men would benefit, and without funding the profits of insurance companies.

But I am just an old patient and the system probably will never change.

meanwhile, During my Lu177 course of 4 infusions, I had Professor Louise Emmett care for me at Waratah Hospital at Hurstville in Sydney for my 3rd infusion. She was sure that for men who have had failed chemo like me, adding enzalutamide to having Lu177 re-sensitised the Pca to enzalutamide, where previously it may have also failed. The enzal made the Pca express more PsMa so the tumors attracted more Lu177, so kill rate was boosted. I began enzalutamide right after No 3 infusion. My onco had no hesitancy to give me a scrip and so Medicare funds this. After 4th Lu177,  Psa had come down to about 2 from a high of 25 before I began Lu177.

Well now that was in mid May and now Psa is 0.7, trending down, so it looks like I've got a good benefit.

The PsMa scan I had after the 4th Lu177 showed much less SUV ( specific uptake value ) for Lu177 al all my bone met sites and basically all soft tissue mets are gone. Well, below what the scan can see.

The report with scan said my bones are healing up.

The CT part of my scan showed no mets that were not shown in the PET part of scan, so it looks like I have not hade a pile of mutations that could be un-treatable by anything, despite the age of my Pca, maybe 14 years, if it began years before diagnosis in 2009.  

Meanwhile Prof Emmett scored the dough to do a trial at St Vincents in Sydney for Lu177 + enzalutamide.

Often the experts have strong evidence from clinical work that this works more than it does not, but a trial is needed to verify it. 

If Psa just goes down to very low, maybe I won't need another PsMa scan and there's a follow appoint by Skype later this year. Dr Macfarlane who works for Dr Lenzo said if Psa goes up again I might have a shot of Ac225, all doable.  

But If I am lucky, by the time my Pca begins to grow again to be a threat, and it probably will, there will be additional new options to buy. Hooray! we need all the options that are possible.

 

The bad news is that a right hip seems to have gone kaput with damage to cartilage, and possibly that's due to damage done in 2010 by original EBRT which was applied in the standard cross formation with beams going in/out through hip joints. Afaiac, EBRT is useless for men with an inoperable Gleason 9 and it causes lots of damage, and to hip cartilages, so use of Lu177 back in 2010 would have worked wonders for me, because I bet I had a pile of tiny mets.

The hip is dodgy, and I had to quit cycling anywhere. Its possible to maybe have an arthroscopy or even a hip joint, but the hip joint is into radiation affected area, invasive, so bleeding is a problem. 

It could be argued that Lu177 is a very disruptive treatment to the status quo where so much "normal" therapy is being offered that does not work very well. The Lu177 in 2010 would have meant I would not have had to spend 5 weeks in Melbourne in 2016 to be the first patient in Australia to get an extra 31Grey of IMRT to my PG via Calypso at Epworth. They had to insert three radio beacons ito PG to guide the Calypso and I bled badly for a couple of days because the applicator needle was about  4mm dia, and the tissue they cut has many small arteries and veins, but it was radiation affected from previous EBRT. Epworth completely missed this inconvenient fact.

So did the cutting make my Psa spread? Well, not likely, because at that time, two mets in lymph nodes were found before anyone cut anything. I had the mets done with 45Gy each with the 31Gy to PG .to make a total of 101Gy, but that's still not enough to kill all Pca in the PG, despite doctors told me. Nobody is sure the extra IMRT worked at all, because I'd been started on Cosadex just before the IMRT, so Psa nose dived to hide what the IMRT may have done.

All that expense could have been avoided with Lu177.

I hope you are well,

Patrick Turner. 

 

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