LU-177/PSMA

User

Posted 07 Jun 2019 at 02:05

Similar article in Express, also talks about early Enzalutamide:

https://expressmirror.uk/prostate-cancer-breakthrough-new-treatment-to-seek-and-destroy-tumours-could-avoid-chemotherapy-2/

Edited by member 07 Jun 2019 at 02:08 | Reason: Not specified

User

Posted 07 Jun 2019 at 07:21

I was at the London Clinic yesterday to undertake my latest PSMA PET San and they confirmed thay have just started providing the Lutetium 177 treatment ( at a cost mind you) and the guys who administer the treatment were extremely positive about it. Apparently the treatment is given on a day visit without need for an overnight stay in hospital

As a side note the chemical components for the PSMA PET Scan are now provided by UCL and are much improved apparently. I will see how much improved they are when I get my results on Tuesday

Good luck all

Dave

Edited by member 07 Jun 2019 at 07:22 | Reason: Not specified

"Incurable cancer does not mean it is untreatable and does not mean it is terminal either"

User

Posted 07 Jun 2019 at 07:47

Dave, that's interesting.

If you get the opportunity to ask when you go back, it would be interesting to hear if they are thinking of (or even heard of) using C11 Carbon Acetate PET scans in the future, which is supposed to be significantly better than PSMA, particularly at PSA levels < 2. I haven't seen it mentioned anywhere in the UK.

Given Carbon Acetate is more "prostate specific" than PSMA (it hooks onto a fatty acid in prostate cells), it would seem to me to be a better agent for carrying Lutetium 177, if they can be chemically combined, possibly avoiding the salivary gland issues. It might make the use of Actinium 255 more viable too (Actinium 255 is better than Lutetium 177 for killing prostate cells, but when carried by PSMA, it's also better at completely destroying salivary glands).

User

Posted 07 Jun 2019 at 09:03

Originally Posted by: Online Community Member

As a side note the chemical components for the PSMA PET Scan are now provided by UCL and are much improved apparently.

I spoke to a radiographer at the Paul Strickland scanner centre this week and she said all Gallium-68 isotope tracers for PET-PSMA scans in Britain come from a sole supplier. So if UCH is now producing the tracer as well, that must be good news.

I wonder if the price will now drop from £2600 to £260, like in India? 😂😂😂

Cheers, John.

https://www.petscaninmumbai.com/psma-pet-ct-scan/

Edited by member 07 Jun 2019 at 09:32 | Reason: Not specified

User

Posted 09 Jun 2019 at 17:10

Hi Roy,

He had advanced cancer which had spread to his bone including leg, sternum, collarbone and most recently eye socket. I believe his count last time was over 500 (but I don’t go with him to any appointments so I maybe wrong!)

I saw him today and the treatment was well received as you say so far no adverse effects. He is very weak but he has been like this for sometime.

I think he is very positive about the treatment, but as he is so weak on his legs we are in the process of adapting the house to accommodate him. Talking to people regarding stair lifts etc.

Thank you lucie

User

Posted 09 Jun 2019 at 17:11

Originally Posted by: Online Community Member

the hospital have advised him not to use public transport to get home they live over an hour from the hospital on the tube due to his risk to others especially the old / young.

If he puts on a radiation protection suit with warning symbols on it, I'm sure he'll get the carriage all to himself...😀

now that would be hilarious!!! I coulD imagine the papers. Strange man in hazard suit clears the underground!!

User

Posted 09 Jun 2019 at 18:54

Hi Lucie

thanks for the update, and pleased the treatment is being tolerated quite well. Did you see the PSMA scan which should have lit the areas of spread like a Xmas tree and where the treatment will target.

looking forward to your updates.

Please send my best wishes to your step father and hopes for a good outcome

all the best

Roy

User

Posted 09 Jun 2019 at 19:00

Hi Roy,

I didn’t see the PSMA scan but I will ask my mother what it looked like!

I appreciate your good wishes and will pass them along.

Thanks

User

Posted 25 Jun 2019 at 05:28

Allow another 10 years for Lu117 to be available on the NHS. However there is a stage 3 trial starting imminently at UCLH. It was supposed to start last month but has been delayed. To qualify you need to have done chemo and all the hormone therapies. So I think they are still recruiting as of June 2019

User

Posted 25 Jun 2019 at 06:00

I've been to see Genesis Care and they have a pretty good set up with plenty of experience. I gather they are in negotiations with BUPA so hopefully it will be part of health insurance in the future. For the moment it is quite expensive at £12,000 per shot and the 68 Gallium PSMA scan at £2,500. However on the latter the good news is that the scan is once again available on the NHS. (It had been stopped for cost saving from Dec 2018 technical grounds cited- that it had not gone through certain 'trials' to varify its safety - but the radio oncologists protested and the administration seem to have backed down) This test has been used for glioblastomas in the UK for over 15 years - before it was used for prostate.

Edited by member 25 Jun 2019 at 06:02 | Reason: Not specified

User

Posted 25 Jun 2019 at 07:58

Originally Posted by: Online Community Member

.............for the moment it is quite expensive at £12,000 per shot and the 68 Gallium PSMA scan at £2,500. However on the latter the good news is that the scan is once again available on the NHS.

When and where did the Gallium-68 PSMA PET-CT scan become available on the NHS?

Cheers, John.

User

Posted 25 Jun 2019 at 08:25

John, i am not going to list all the hospitals where the scan is available - it would mean phoning round every trust in the country! UCLH does it and so do some hospitals that treat Glioblastomas. It has been available for many years (for Glioblastomas) and more recently for prostate if your radio oncologist consultant could swing it. It was stopped in December 2018 but it is being allowed again now. I don’t know the state of all trusts in the country.

User

Posted 25 Jun 2019 at 10:59

I understand that only a very few NHS hospitals have the facilities for G68 PSMA PET-CT scanning.

This trial shows how effective it is. I read that is so much more accurate that Choline scans in one country have been abandoned altogether!

http://www.practiceupdate.com/content/assessment-of-68ga-psma-11-pet-accuracy-in-localizing-recurrent-prostate-cancer/81710

In case you can’t access the results of the trial above, (it may be subscription only), the summary of its conclusions are here:

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In this prospective single-arm trial of 635 men, 68Ga-PSMA-11 PET had an 84% to 92% positive predictive value and a 75% overall detection rate of biochemical recurrence in patients with prostate cancer and a median PSA of 2.1 ng/mL. Agreement among 3 readers of the PET images was substantial.

68Ga-PSMA-11 PET provides early detection of metastases and contributes highly relevant information in a biochemical recurrence setting.

– Jeffrey M. Wiisanen, MD

Cheers, John.

Edited by member 25 Jun 2019 at 12:27 | Reason: Not specified

User

Posted 24 Aug 2019 at 15:27

So, I saw my NHS consultant at a hospital in Slough this week. I mentioned to her that forum members had been talking about Lutetium treatment at Genesis Care in Windsor and she confirmed that she is, indeed, one of the consultants leading on that particular treatment. From talking to her, I think Windsor is probably a bit more expensive than Finland. She was aware that men were travelling to Finland for the treatment. One of the main challenges with the treatment was that some men get a few months' benefit from it and yet there are others who seem to get much longer. They are trying to understand why that is the case. I asked when, if ever, it would be available on the NHS. She said the NHS would want lots more data and it wouldn't be on the agenda for at least 5 years at the very earliest.

She told me she hoped I would never need to consider the treatment. I asked her for a discount if I ever did. She laughed.

If I did need this treatment, I would have every confidence in her abilities as an oncologist, and the Windsor treatment centre is 10 minutes' drive away.

Ulsterman

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