a Lu177 treatment will treat what you see with a PSMA PET/CT. The PSMA PET/CT shows the PSMA expression of the tumor lesions which is sufficient for a Lu177 treatment. If you do not have enough PSMA expressing tumor cells showing up on a PSMA PET/CT, the ligands you get with the infusion will attack healthy cells because they cannot find tumor cells to attach to. Also, the PSMA expression is higher if you are castrate resistant.
You will have the best results with a PSMA PET/CT if the PSA value is above 1.0 ng/ml. So with your current PSA value below 0.1 you will see no tumor lesions. There is nothing to be treated with Lu177.
The dead tumor material does not clog up the kidneys. This are dead cells which your body takes care of like any other dead cells. The unused ligands you got with the infusion are excreted via the kidneys and that is why they check your kidneys before the Lu177 treatment. If the kidneys do not work, the radiating ligands will gather in the kidneys and destroy these.
They focus for later stages of PCa because the Lu177 treatment is not FDA approved and thus should only be used after everything else failed. In Germany this is the official recommendation but many ROs will treat you earlier, provided you are castrate resistant and failed Zytiga.
You cannot use this therapy to clean up circulating tumor cells after surgery. Six months of ADT will attack remaining cells instead. Like a chemo for colon cancer patients after surgery. This is an alternative approach your URO may not agree to.Adjuvant Androgen Deprivation for High-Risk Prostate Cancer After Radical Prostatectomy: SWOG S9921 Study
Post Edited (George_) : 11/13/2019 12:52:26 PM (GMT-7)