Prostate cancer is the second most common cancer among men, and thankfully, it’s very treatable. In fact, when detected and diagnosed early enough, the survival rate is almost 100%! Sometimes, however, prostate cancer isn’t identified until it’s developed into a more advanced stage or it’s developing more aggressively, making the survival rate much lower. According to the American Cancer Society, the five-year survival rate for distant prostate cancer drops all the way to 32%!
But men in this category no longer have to feel hopeless. Thanks to an emerging new therapy, men with advanced or metastatic prostate cancer have a better chance to survive and live well in the long term.
Traditional Treatments Used for Metastatic Prostate Cancer
Men with advanced prostate cancer have several treatment options to choose from, including:
Hormone therapy. This type of therapy uses drugs or surgery to block the production of testosterone. It does, however, come with side effects. Men who undergo hormone therapy may experience low sex drive, erectile dysfunction, and symptoms of male menopause, including hot flashes, weight gain, and brain fog. Some men who have undergone testicular surgery may choose to have a testicular implant (prosthetic) put in place.
Chemotherapy. Men with advanced prostate cancer who no longer respond to hormone therapy may benefit from chemotherapy. Side effects from chemotherapy for advanced prostate cancer can include fatigue, hair loss, and weight loss due to nausea and poor appetite.
Bisphosphonates. This drug can relieve pain and slow the growth of cancer cells that have spread to the bones — side effects of this type of treatment range from nausea and diarrhea to possible kidney problems. Although not as common, some patients may experience jaw bone damage, which can lead to mouth issues, such as tooth loss.
Your doctor might recommend one or more of the above treatments if your prostate cancer has returned or if other treatments have been unsuccessful. Some men choose to go forward with these recommendations. Others, however, choose to decline them to avoid significant side effects. Because of advancements made through years of research and development in clinical trials for prostate cancer, a new option is available that can help these patients.
Pluvicto: A New Category of Prostate Cancer Treatments for Men With Advanced Prostate Cancer
Pluvicto™ (lutetium Lu 177 vipivotide tetraxetan) is a new therapy recently approved by the U.S. Food and Drug Administration (FDA). This drug is considered a targeted therapy. It was designed to treat a certain type of advanced cancer called prostate-specific membrane antigen–positive, metastatic castration-resistant prostate cancer (PSMA-positive mCRPC).
Pluvicto was used in clinical trials on actual prostate cancer patients. Under the careful watch of cancer researchers, it was determined that this drug was a safe and effective treatment option for some men with advanced prostate cancer. After the data was reviewed, it was eventually approved by the FDA.
Patients receive PSMA treatment every six weeks in an infusion room, where other IV cancer treatments are given at their cancer center.
Am I Eligible for Treatment with Pluvicto?
Not all prostate cancer patients are good candidates for this treatment. Since Pluvicto is designed to treat a specific type of advanced prostate cancer, some general requirements must be met in order to be considered eligible for the treatment. These qualifications include men who have:
Metastatic, or advanced prostate cancer that developed in the prostate gland and has spread outside of the prostate
Cancers that have developed to the point where they do not respond to hormone therapy
Cancer that progressed after treatment with taxane-based chemotherapy
Metastatic castration-resistant prostate cancer
Schedule an appointment with a prostate cancer oncologist if you feel you meet the above criteria. They will evaluate your individual case to determine if treatment with Pluvicto is right for you. Studies are currently underway, testing how effective Pluvicto is for men with early-stage prostate cancer and its use in combination with immunotherapy treatments.
How Pluvicto Works Against Cancer Cells Outside the Prostate
Prostate-specific membrane antigen (PSMA) is a protein that doesn’t exist in normal tissue but can be found in nearly all prostate cancer cells. To help make it easier to detect cancer cells on imaging tests, doctors use Pylarify®, a tracing agent that finds and attaches to the PSMA protein on the cancer cell’s surface.
Identifying the PSMA protein gives Pluvicto a precise target. The presence of PSMA on cancer cells allows your oncologist to see the prostate cancer on PET or CT scans.
Pluvicto is given as an intravenous (IV) infusion, allowing it to reach cancer cells throughout the body, including bone or soft tissue. As a targeted therapy, Pluvicto radiation hones in and binds to the cancer, administering precise doses of radiation directly to the tumors without affecting healthy tissue. When the cancer cells absorb the radiation, they die.
Pluvicto is not a drug or hormone used to slow the growth of cancer, like other targeted therapies, but rather a unique type of therapy that can destroy tumors.
Side Effects Associated With Prostate Cancer PSMA Therapy
The targeted radiation in Pluvicto travels only a short distance outside the cancer cells, leaving surrounding healthy tissue largely unaffected. This means that there are fewer side effects to worry about. Compared to chemotherapy, Pluvicto causes modest side effects, but not for all men. When men do experience side effects, they often include fatigue, loss of appetite, or dry mouth. If your red and white blood cell count drops, your prostate cancer doctor may prescribe a lower dose.
Certain patients, such as those who had low blood counts or kidney issues like renal obstruction before therapy, may be less suitable for the drug. Patients experiencing urinary inconsistency should be closely monitored while taking Pluvicto.
PSMA Treatment Available at Compass Oncology for Advanced Prostate Cancer Patients in Portland-Vancouver
While the oncologists at Compass Oncology care for men with all stages of prostate cancer, be sure to reach out for a consultation to discuss the possible use of Pluvicto if you have already completed prostate cancer treatment without success – or it has returned. If you are seeking a second opinion on treatment, the prostate cancer specialists at Compass Oncology are here to help. We will discuss all the treatment options available to you, including this new and promising therapy for men with advanced prostate cancer.
If you're in the Portland-Vancouver area, request an appointment at Compass Oncology to learn more about our collaborative approach to prostate cancer care.