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by dangwhy 1113 days ago
My father is in this situation with prostate cancer. First line therapies have stopped working and now its on to chemo. I am hoping chemo won't damage him too much.

There are also radioligand therapies like lutetium 177 but they haven't been sequenced on chemo naive patients yet. So soc is chemo first.
1 comments
haldujai 1113 days ago
I wasn’t involved in this study but the cancer center I just left was one of the sites for the upfront Lu177 vs chemotherapy trial. Speaking casually with the physician involved recently he said the results weren’t promising thus far.

I don’t think this is published yet and I’m not familiar with prostate ca treatment literature so take this with a grain of salt.

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dangwhy 1113 days ago
my father is in india where they've been giving lu177 ( and others) before chemo for quite a while ( other countries being germany and australia ) . Forums are awash with 'success stories' . There are many clinical trials currently in US and canada. Some have published results showing 'non inferiority' in small sample sizes but most are in progress

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627907/

https://clinicaltrials.gov/ct2/show/NCT04647526 this one was supposed to publish some preliminary results in q1 2023 but i don't see any updates :/

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haldujai 1113 days ago
> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627907/

Non-inferiority studies aren't sufficiently powered to answer the question but up-front Docetaxel is pretty old-school. My urology days are long behind me now but even in my residency abiraterone/enzalutamide had taken over as in:

> https://clinicaltrials.gov/ct2/show/NCT04647526 this one was supposed to publish some preliminary results in q1 2023 but i don't see any updates :/

This is the trial I was referring to, I don't think they're done with the analysis/writing yet.

I have no numbers or data hence my casualness but our nucs physician was really excited 5 years ago and lukewarm when I recently asked him if they were finally taking over mCRPC care over a beer.

Again grain of salt, but my impression from that convo was it's going to end up another line of therapy (mCRPC treatment is a game of kicking the can down the road as long as possible).

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