Metastatic prostate cancer is usually treated with medication to suppress male hormones, a process known as androgen deprivation therapy (ADT). Some patients with advanced disease may also benefit from chemotherapy. Over time, prostate cancer can develop resistance to treatments. It may stop responding, progress or even come back while the patient is on hormone therapies. At that point, doctors refer to it as castrate-resistant prostate cancer.
This form of cancer is particularly hard to suppress, but doctors at Capital Health Cancer Center have a new and effective treatment option. Many cancers that are castrate-resistant still express prostate-specific membrane antigen (PSMA), which can be targeted with a novel radiotherapeutic drug.
If you have PSMA-positive prostate metastatic castration-resistant cancer that hasn’t responded to hormone therapy or a combination of chemotherapy and hormone therapy, your doctor may recommend a treatment called lutetium Lu-177 vipivotide tetraxetan, or Pluvicto®.
Here’s what you need to know about Pluvicto, how it works and what makes it unique.
1. Pluvicto Works by Targeting Cancerous Cells
Unlike other therapies that may affect large amounts of tissue, Pluvicto targets specific cells. It contains a targeted substance that seeks out cells with PSMA proteins on their surface. These cells are generally prostate cancer cells.
Pluvicto then enters the targeted cells and releases radiation, which harms or kills the cancer cells. This precise approach allows Pluvicto to spare healthy tissue while destroying prostate cancer cells anywhere in the body.
2. Pluvicto Treatment Starts With a PET Scan
Positron emission tomography, or PET, is a type of imaging scan that lets your doctors know where cancer might have spread.
A special PET scan called a PSMA PET tracks PSMA-emitting prostate cancer cells in your body using radioactive tracers. Injected into your bloodstream, these tracers attach to cells that have PSMA on their surface. Although the tracers emit only slight amounts of radiation, it’s enough to show up on a special camera.
This scan will help your doctors determine whether Pluvicto can target your cancer effectively.
3. Pluvicto Treatment Is Short—Just 6 Sessions
If your doctors decide you’re a candidate, you’ll receive a series of IV injections containing Pluvicto. The injection takes about 10 minutes to administer. You’ll also receive tests and scans at the treatment center.
When you think about going to an infusion center for chemotherapy, you may imagine sitting in a treatment chair day after day. However, Pluvicto treatment saves you time. You’ll visit the treatment center for just one session every six weeks until you’ve received a total of six doses.
4. Pluvicto Is Not Chemotherapy
Even though you receive Pluvicto as an infusion or injection, it isn’t chemotherapy. Instead, it’s a form of therapy called a radiopharmaceutical—a combination of a medical drug and a radioactive agent.
5. Pluvicto Makes You Slightly Radioactive
You won’t glow in the dark after receiving Pluvicto, but you’ll be radioactive enough that you may affect those around you. After each round of Pluvicto, take steps to protect your loved ones:
- Stay at least 3 feet away from people for two days after each session.
- If you interact with children or pregnant women, maintain a distance of 3 feet or more for seven days.
- Don’t share a bedroom with anyone for the first three days after treatment. After that, avoid sharing a bedroom with children for seven days. Don’t share a bedroom with pregnant women for 15 days after treatment.
Luckily, the radioactive substance in Pluvicto clears your body fairly quickly. About half will be gone in just two days. You can help flush the radiation from your body by drinking plenty of water.
6. Pluvicto Has Side Effects
Like other cancer therapies, Pluvicto can cause side effects. During treatment, you may experience:
- Constipation
- Decreased appetite
- Dry mouth
- Fatigue
- Nausea
People who receive Pluvicto may also have reduced red blood cell, white blood cell and platelet counts. You’ll receive regular blood tests throughout your treatment to make sure you stay safe.
Pluvicto can also damage your kidneys—another good reason to drink plenty of water before, during and after treatment. Your doctors will regularly test your renal (kidney) function.
7. Compared With Other Treatments, Pluvicto Extends Life
Before medications become available to treat cancer patients in the general population, they undergo clinical trials to ensure they are safe for use and more effective than the current standard of care. In one large clinical trial reported in the New England Journal of Medicine, Pluvicto proved more effective than standard-of-care treatment for metastatic prostate cancer in several important measures:
- Imaging-based progression-free survival: Cancer took more than twice as long to progress, according to imaging studies, in men who received Pluvicto.
- Overall survival: Men who received Pluvicto lived longer than those who received standard of care, and many were still living at the end of the trial.
- Bone metastases: Pluvicto delayed cancer spreading to the skeleton. In fact, some men with bone metastases at the start of the trial experienced improvement in their condition.
The Bottom Line
While Pluvicto for prostate cancer does have some risks and side effects, many men find it quite tolerable. Most importantly, Pluvicto can prolong life and delay symptoms longer than other treatment options for late-stage, treatment-resistant prostate cancer. If you’re struggling with prostate cancer that’s come back after treatment, Pluvicto could give you precious time with your loved ones.
Are you facing metastatic prostate cancer? Request a consultation with an oncologist at Capital Health Cancer Center to discuss your options.