Prostate Cancer Survivors






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Re: Castion resistant advanced prostate cancer

The following information on Lutetium 177 was passed along to me by a fellow PCa warrior.

"I’ve put a bunch of links together regarding the treatment - Peptide Receptor Radionuclide Therapy - or PRRT. Basically, they find that certain tumors have receptors for certain chemicals. They attach Lutetium 177 (a radioactive isotope) to this chemical and give it to the patient by IV. The chemical takes the isotope directly to the tumor. The isotope then burns the tumor over a period of time. There are little to no side effects to the patient.

Dr. Richard Baum pioneered PRRT for neuroendocrine tumors but now is doing quite a bit with prostate cancer patients. Dr Scott Tagawa is leading the research in the US at Cornell University in New York. However, it is only in Stage 2 trials. Trials are ok but of course they are cookie cutter - prescribed doses and timing that are created for the trial; not the patient. Dr. Baum customizes his doses based on the patient, tumor load etc… They are way ahead over in Europe."

Here's my (Don O) layman's analysis:

I have reviewed the materials more carefully. Before I say anything more, please be aware that in-depth scientific analysis of technical reports such as these is beyond my capabilities.
Thus far this form of therapy is used only on end-stage metastatic and/or castrate resistant cancers. Based on limited data it is effective for about 80% of those treated for a period of three years.

At present neither of us are logical candidates. Like you, I appear to be responding well to xtandi. After only three weeks or so on this drug my PSA dropped back to .11 after a steady climb to .76 over the past 12 months.

Personally I would not pursue a new drug like this on my own. And only when I meet the treatment criteria would I discuss the possibility of this form of therapy with my oncologist and take my cues from him or her. My guess is that Dr. Myers would rule it out on the basis that it is experimental and unproven.

On the other hand it sounds very promising

Re: Castion resistant advanced prostate cancer

It sounds like an exciting treatment, but killing all the types of cancer cells one might have is still going to require multi-modal methods:

"Up to a third of those men treated to date show progressive disease despite treatment. This is likely due to a variety of factors. One important factor is whether the tumour cells uniformly express a high density of the PSMA receptor."

"Heterogeneity of PSMA receptor activity within the tumour population may mean that some sites will not respond to treatment with 177Lu PSMA, which will manifest as disease progression, and a rising PSA."

Another good thing is that it should be approved very quickly as it involves a drug (now with 177Lutetium attached) that has already been used as a contrast enhancer.