Well I spoke with the Nuclear Medicine departmental manager of the Royal Free Hospital today. I was advised that they do LU-177 combined with something else, mainly for cancers of the gut but not for PCa and not the PSMA test. Furthermore, they were unaware of anybody else doing the PSMA and LU-177 test in the UK. However, I have 'lifted' the following from a Macmillan forum from which it transpires that somebody had a PSMA done at the Marsden to check whether they might be suitable for the PSMA/LU-177 procedure in Germany. " ....
Posted by MelanieL
5 Mar 2017 11:52 AM
We have recently heard and investigated a therapy currently being tested in Germany with LU-117. It is a type of radiation therapy. Since the Aberaterone has almost stopped working for my husband, we have to think about what to do next, and this therapy seems to be an option. We are wondering if anyone here has ever had it or looked into it?
Posted by gregm
6 Mar 2017 12:23 AM
Hi Mel and Paul,
I think you'll find people with experience of Lutetium (LU-177) in the neuroendocrine cancer groups, and I think Ronny.a may have experience/looked into that treatment. Whilst the treatment is for a different cancer, they may be able to give first-hand experience of how they found the treatment.
Posted by Ronny.a
6 Mar 2017 9:03 AM
Hi Melanie, I think you mean Lu-177 or Lu = Lutetium or sometimes called Lutathera. It's much more commonly known as PRRT. (Peptide Receptor Radionuclide Therapy). It's not really on test, they've had it for years across Europe but perhaps not for Prostate. It was available on the Cancer Drugs Fund for Neuroendocrine Tumours but it was removed from routine availability in Nov 2015. NICE are currently re-evaluating it and there's a small chance it will become available later this year for Neuroendocrine Tumours.
With Prostate, they mix the Lu-177 (a radionuclide) with something called PSMA which prostate tumours are known to secrete. This enables the drug to target the tumours and do their thing. This is actally the same method for Neuroendocrine Tumours except they oversecrete a different hormone.
Something also useful to know. Neuroendocrine Tumours also have a diagnostic and surveillance scan called Ga68 PET which works in a similar way. You mix the somatostatin analogue with some radionuclide and it binds to tumours. Then using a gamma camera you scan for pictures and the tumours light up because the gamma camera finds the radioactivity.
So they can do the same for Prostate cancer using Lu-177 and PSMA. Much more sensitive than current methods of scanning. I'm fairly certain they will be using this as part of the German trial as this will not only confirm location of tumours but will also check to ensure the patient is expressing sufficient receptors needed for the treatment to work.
Good luck Melanie
gregm and 1 other like this
Posted by sungura
28 Jul 2017 5:57 AM
My husband is about to have a PSMA PET scan at the Marsden with a view to seeing if will be suitable for treatment in Germany. Has anyone else out there had experience with this?
He has bone metastases - castrate resistant prostate cancer - PSA 750 and going up. Has already had enzalutamide, abiraterone, radium 223, strontium, docetaxel etc.
Posted by MelanieL
28 Jul 2017 7:51 AM
That is really interesting. My husband and I have been very interested in this therapy for months now, the one with LU177 in Germany. However, the fact that a recent CT showed that the cancer had spread to the liver made it necessary to react fast and he is now on Docetaxol. But we still keep LU177 very strongly in mind for after the Chemo. Unfortunately, the PSMA scan is not available here in Ireland, so we would either have to get it done in Germany or else go to England.
Good luck with it all! And please keep us posted!!!
Mel and Paul.
Posted by sungura
30 Jul 2017 11:38 AM
Hi Mel, So sorry to hear about your husband and that it has spread to the liver. How is he getting on with the Docetaxel? I believe the treatment in Germany will work for both bone metastases and for cancer that has spread to other organs.
I will let you know how it goes. We live in Kenya, but will come to the Marsden for the scan and then take it from there.
Posted by sungura
17 Aug 2017 10:01 PM
We have now had the results of the PSMA PET scan and it seems my husband is suitable for the treatment in Germany so has been referred there which is very exciting. Has anyone else in the community had this therapy? We do not know how long we will have to wait for an appointment and what is involved so it would be useful to get more info."
I was previously monitored by the Marsden before they referred me to UCLH for HIFU and they agreed hat if my PSA continued to rise I could get my GP to refer me back to them. In the light of the foregoing, and because UCLH will not give me a PSMA scan (though as we know they have the wherewithal to do so), because they just want me treated with HT rather than another intervention, I have decided to investigate the Marsden/German route. It would possibly be less expensive to arrange this myself rather than as a package as detailed in the previous link I gave. Should the cost be not excessive compared to other German Hospitals, I would opt for treatment at University Hospital Heidelberg where I have a contact and know the area well, having had my original RT there; also, together with the DKFZ they originated the 68 Gallium PSMA test. I am now above the PSA level they suggested I have the PSMA test there or elsewhere.
Yes I will update with progress as I am aware others may find of interest.