So, where I left off with blog post #27, my treatment regimen with Pluvicto had finally been approved, secured, and had begun. That was near the end of April 2023 (it’s now the end of October 2023) and I have held off posting much in hopes that I would have good news to report. And boy, do I!
There is one bit of information that I need to share for context before I get into the good news. Historically, I have been a bit of an underperformer when it comes to treatment for advanced prostate cancer. If a certain type of treatment was supposed to buy a typical advanced prostate cancer guy five more years, I’d be lucky to get two out of it before my PSA would begin rising again. Oral treatments like Xtandi could typically be expected to be effective for two or more years, and I was failing at four months. Chemotherapy – pretty much the mother of all cancer treatments – was largely ineffective against my cancer.
Despite the treatment frustration that had built up over the years, I went into this Pluvicto treatment regimen with high hopes. My past experiences caused me to temper my enthusiasm ever so slightly, but I was also mindful of the many positive reports I had heard from medical oncologists about the effectiveness that Pluvicto was showing in early data.
To review just a bit, Pluvicto is what is referred to as a “radioligand” treatment. In practical terms, what it does is use a radiotracer (such as Gallium 68 or Pylarify) to locate the prostate cancer cells, and a radioisotope (in this case, Lutetium-177) to destroy those cancer cells. This is what they call a “PSMA-targeted treatment,” as it can work in guys that have a base layer protein called “PSMA” (prostate-specific membrane antigen) present on their prostate cancer cells. Thankfully, about 80% of guys with prostate cancer do express this PSMA protein on their prostate cancer cells.
So far, the data on treatment with Pluvicto has been great, showing not only a quantifiable life-extension benefit, but also good durability. That said, even amongst the guys that are “PSMA positive,” only about 65%-70% will show an effective response. But it’s a great start, and there will surely be additional PSMA-targeted treatments that will be coming along. Despite these limitations, Pluvicto appears to be – at the very least – a “game changer” in terms of prostate cancer control.
When I started treatment on April 21, 2023, my PSA was 25 and climbing. Since then - and remember, PSA is like golf… the lower the number, the better:
May 13, 2023 11.3
June 19, 2023 9.6
August 4, 2023 5.1
August 31, 2023 3.6
September 20, 2023 2.9
For a guy that has not had the best luck with treatment, these are STUNNING results and a good indication the treatment is working in my case. In my next post, I’ll address what happens when my PSA (inevitably) starts to rise again.
Until next time,