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New FDA Approved: Pluvicto (Lutetium-177) for Advanced Prostate Cancer | Mark Scholz, MD | PCRI

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Based on positive results from the VISION trial, Pluvicto (lutetium-177) was recently FDA approved for men with PSMA-positive, castrate-resistant prostate cancer after chemotherapy-meaning that metastatic lesions have been discovered on a PSMA PET scan, that the cancer is no longer responding to hormone therapies, and that chemotherapy has already been used. This newly available therapy is providing hope for men who previously would have had very few options. While its current indication is limited, studies are ongoing to determine if there is a benefit to using Pluvicto earlier in the treatment sequence. To learn more about Pluvicto, visit www.hcp.novartis.com/products/pluvicto.
0:08 What is Pluvicto (lutetium-177) and when will it be available to patients in the United States?
2:43 Is Pluvicto only available for patients who have hormone-resistant prostate cancer after chemotherapy?
3:34 Is dry mouth from Pluvicto a temporary or permanent side effect?
3:57 Would chemo be stopped to administer Pluvicto? What is its place in the sequence of treatments?
5:16 Do patients have to have lesions discovered by a PSMA PET scan to be eligible for Pluvicto?
6:17 Will insurance cover Pluvicto for oligometastatic disease (a small number of metastases) or will it only be covered for patients with extensive metastases?
8:00 Can any provider capable of providing a PSMA PET scan also able to administer Pluvicto?
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Опубликовано:

27 авг 2024

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Комментарии : 51

@andrewmacfarland5253 Год назад

I just had my 5th (out of six) infusion with Pluvicto. {age 77, stage 4, mets to ribs, hips, spine} PSA is down, no new mets, nothing major with side effects. Some fatigue and dry mouth, goes away a week after treatment. I’m told that I’m my case, not a cute, but hoping to just slow it down. Pluvicto is so much better than chemo (docetaxel), no lie! Pretty sure it’s working well. I feel better than in a long time. If your doctor says you are eligible for Pluvicto, I urge you to go for it! But be sure your insurance covers treatment: cost around $40,000 each treatment.(of six). I wish all of us the very best.

@koof1776 Месяц назад

Update please?

@brentmassingale2161 2 года назад

Well hallelujah praise God! He has given the doctors insight in order to put together another weapon against this horrible affliction. Will we ever see a day in which the insurance companies put people before profit? That remains to be seen..

@marvs4321 2 года назад

What is a shame is that the availability of this new treatment in the eyes of physicians is based upon insurance companies acceptance and willingness to pay. When will physicians offer ALL treatment choices to patients and let the patients work with the insurance companies and their FSA,HSA, etc. to pay for treatment.

@stevenpeterson659 2 года назад

While the US Pharmaco-industrial complex plays around and jacks the price up; the rest of the world has moved on to other radioligands and radioligand combinations and has already started offering radioligand therapy earlier in the disease. Going overseas still remains the best option for modern therapy.

@thomashenderson6804 2 года назад

I am grateful for this uploaded video. :)

@7kmkeane 2 года назад

Do not understand why this is only offered if you are metastatic castration resistant post chemo failure? Do you really have to wait until you are that desperate? Why would this not be reasonable to use on aggresive (4+3) caught early if you are PSMA positive on a scan, and therefore have a reasonable chance to stamp it out early instead of going through all that progression and agony? The heck with insurance approval, maybe some people would be willing to travel to Germany for treatment to try and save their lives instead of sitting around being progressively swarmed by cancer while waiting for the nod of approval from the FDA/insurance masters of the cancer universe.

@ThePCRI 2 года назад

It has been investigated in small numbers of men with metastatic hormone-sensitive disease, so hopefully larger studies will be able to replicate those good results and it will be available to men in more situations. I might be mistaken, but I believe it has the same indication in Germany, "The therapy is offered to patients with metastasized prostate cancer, with disease progression despite hormone therapy or chemotherapy." klinikum.uni-muenchen.de/Klinik-und-Poliklinik-fuer-Nuklearmedizin/en/Nuclear-Medicine-Therapy/Prostate-Cancer-Therapy/PSMA/index.html That webpage also gives a brief reason why new medications are approved in this order, "It is the application of an effective, but not yet an approved, therapy for individual cases. It may be applied in patients with progressive and otherwise untreatable diseases. However this individualized treatment has so far no proven benefit in rigorosly controlled prospective studies. Therefore it differs from therapies which are proven state of the medical art in that risks and side-effects are not fully known." And the FDA sometimes requires studies be performed in the United States for different reasons, for example, if a study conducted in a foreign country used an ethnically homogenous patient population; since the United States is diverse, they want to ensure to the treatments are effective and safe for general application, especially considering that cancer is a disease of genetics. Or, if the studies do not meet the level of rigor required by the FDA, etc.

@jacksonripholmes3236 2 года назад

Thank you

@myopinion9518 Год назад

When the “patient” said it worked, did he go into remission or was his life prolonged? And for how many months on average does Pluvicto prolong life? And my very best to Van Lacour. Thank you for sharing. So happy for you. I hope your health maintains and you have a happy joyful life.

@stevef7814 2 года назад

Would be great to see trials for non metastatic patients. I can see that void filled soon, but will be out of pocket as all focal therapies were just a few years ago.

@jgueva4457 2 года назад

In great!! They will know what the average cost of treatment will be?. Thank you very much

@johnsuechandler478 2 года назад

We were told that if you're not having pain from the bone metastis (less than 5), then they won't do radiation. They said it's stage 4 and can't be cured. Treating with Lupron 6 month shot and Erleada. Thank you for these videos.

@ThePCRI 2 года назад

There is a lot of variation between different doctors and institutions. Oncologists who specialize in prostate or genitourinary cancers are more likely willing to use radiation on limited bone metastases in an attempt to achieve a cure or a longer remission than general oncologists because the theory that supports this treatment is specific to prostate cancer and not to most other cancers. Also, it has only recently become possible with the advent of PSMA PET scans since, in most cases, all previous scans lacked the sensitivity to discover metastases in a nascent state, and so there is not robust literature proving how effective it is. So, a lot of general oncologists might avoid it out of ignorance or to protect themselves legally, and a lot of institutions may refuse to provide it for cost-saving reasons. That said, weighing the risks and benefits, a lot of oncologists who have a lot of experience with prostate cancer patients are likely going to be willing to try it.

@salsamink 2 года назад

How long does this treatment take to work? How long does it seem to keep the cancer away until the cancer returns?

@noads6566 2 года назад

Why would this treatment not be offered as adjuvant therapy to all prostate cancer patients? Seems it would be much more effective to nip any unseen metastases in the bud rather than wait and wonder about recurrence and metastasis after RP or RT.

@stevef7814 2 года назад

Question for admin.: How does urologist/radiologist determine, after initial PSMA scan, if patient will be a responder to Lutetium/theranostics? Thanks

@PanAmPatti 2 года назад

Does anyone know what are the “other“ countries that have been doing this for a while? This would be helpful to know so that we could do a little more research on the success in those countries. This sounds SO promising! Right?

@ThePCRI 2 года назад

Hello Trish, both Germany and Australia have been doing work in LU-177. We will research some references for you. Here is a study that shares more information: www.nejm.org/doi/full/10.1056/nejmoa2107322

@PanAmPatti 2 года назад

@@ThePCRI Oh my gosh! Thank you so much for responding with an answer about Germany and Australia plus the link! This is the most informative PC place to find out what’s going on in the PC world.

@cheunga33 2 года назад

Hong Kong is also a place where Lutetium 177 is used for prostate cancer patients.

@scarface548 Год назад

india too

@anmolmishra7906 Год назад

India

@stevef7814 2 года назад

To those focusing on ills of insurance companies, where there's a will there's a way. Don't expect quick changes adopting new treatments.

@Dmunson3 2 года назад

I just completed the PSMA Test.March 18th. I was told Medicare has not assigned a billing code and I'm waiting for over a month. Now my Doctor is recommending I do Radium 223. But I have to wait till June 15th to start. What is the normal wait period?

@salsamink 2 года назад

Since met cancer is usually in the bone, what is the major side effects when the bone mets are destroyed? Wondering the use of those bones after the treatment or what is given for that bone repair after treatment?

@bobbarker5884 2 года назад

I know Vit D is recommended. I would use 10,000 iu daily even if you don't have treatment. 10,000 has been proven safe and beneficial for almost everyone! Taking Vit. K-2 along with Vit. D is important too but make sure your Dr. says it's safe first.

@ramakrishnaguptamudalagiri4752 6 месяцев назад

Can we try this treatment for prostate cancer instead of radiotherapy

@ramakrishnaguptamudalagiri4752 6 месяцев назад

Can we take this treatment as first type of treatment instead of a radiotherapy

@tomrayfield3291 2 года назад

Have asked for PSMA scan to no avail; I hate being on pain meds. Seems that’s the only answer I get. Any suggestions????

@ThePCRI 2 года назад

We have patient advocates on our free helpline who may be able to help you out. Feel free to contact us; our information is available at pcri.org/helpline.

@DCGreenZone 7 месяцев назад

Just read that ADT drives bone mets.

@ransomcoates546 2 года назад

Does this technology of having a way to locate precisely where prostate cancer is exist for any other type of cancer?

@stevef7814 2 года назад

Just prostate cancer from what I have read. Apparently work is being done on breast and brain cancers.

@ransomcoates546 2 года назад

@@stevef7814 Thanks.

@anmolmishra7906 Год назад

What dose (in MCI) is generally given to a older patients with mCRPC(let's say 75 years-old) with healthy blood counts?

@salsamink 2 года назад

If you get spot/concentrated radiation, does this make you ineligible for this treatment?

@ThePCRI 2 года назад

Hello, I will add this to our list of questions for upcoming videos. In the meantime, our helpline may be able to provide you with information on that. You can find our contact information at pcri.org/helpline.

@salsamink 2 года назад

Prostate Cancer Research Institute any update video on Lu177

@bobbarker5884 2 года назад

I was still eligible after 2 rounds 6 months ago. But they keep pushing back the start date by a month, every month....still waiting

@salsamink 2 года назад

@@bobbarker5884 thank you!

@bobbarker5884 2 года назад

@@salsamink Quite welcome! I just found out I'm scheduled to start it in September so it is starting to move along now. Hopefully the wait is over

@danny6905 2 года назад

Does this work on early stage Gleason 6 cancer?

@ThePCRI 2 года назад

That is unknown because it has only been studied on patients with advanced prostate cancer who have already been treated with chemotherapy. It may be studied earlier in the disease course, but is unlikely to ever be studied in Gleason 6 prostate cancer since Gleason 6 is not a dangerous type of cancer and the treatment would almost certainly be worse than the "disease."