MENUPluvicto treatment gives prostate cancer patient another chance
Contributed by Valerie Goodwin
New treatment for metastatic castration resistant prostate cancer helped man get back to his hobbies
Photos courtesy of the Reynolds family
After multiple rounds of treatments for his metastatic castration resistant prostate cancer, 69-year-old Donald Reynolds received the news that there were no more treatment options for him.
In a last attempt to find something that would work, one of Reynolds’ family members came across a dosimetry research study at University of Michigan Health for Pluvicto, a radioactive drug treatment for metastatic castration resistant prostate cancer.
Reynolds and his oncologist believed it was worth applying for the trial to see if the results could benefit him, and just two days after applying he received the call that he had been selected to participate.
Giving new treatment a chance
Before beginning his Pluvicto treatment at U-M Health, Reynolds underwent a scan that located metastases in 12 areas of his body including the lymph nodes, soft tissue and bones.
“I was originally diagnosed with prostate cancer in 2010,” said Reynolds.
“I had my prostate removed shortly after that diagnosis and thought everything was okay. In 2018 we discovered the cancer had metastasized throughout my body.”
The scan results confirmed that Reynolds would be an ideal candidate for the clinical trial.
Recently, the radioactive drug therapy named Pluvicto received Food and Drug Administration approval. Pluvicto is administered through infusion to patients with metastatic castration resistant prostate cancer that are left with no further treatment options.
The drug targets the metastasized cells within the body and works to reduce their size and is well tolerated without harming the rest of the body.
“The majority of patients who receive Pluvicto have few side effects and the treatment will see a decrease in the number of cancer cells and in some a reduced size of their metastases,” said Ka Kit Wong, M.B.B.S., a clinical professor of nuclear medicine at University of Michigan Health and the director of the Therapy Nuclear Medicine Clinic. Wong was also the lead nuclear medicine physician for Reynolds’ treatment.
“For patients that have gone through multiple rounds of different treatments for their metastatic castration resistant prostate cancer that are no longer working or causing side effects, this treatment can offer positive results with few physical side effects to help bring relief to patients.”
The treatment consists of six sessions where the patient is given one dose of the Pluvicto drug once every six weeks totaling six rounds of treatment by the end of the course.
In addition to the treatment, the patient may have imaging to see if the treatment is effectively targeting the metastasized cancer after completion of treatment or sometimes during the Pluvicto treatment.
Reynolds was eligible to receive Pluvicto at U-M Health as a clinical treatment option and the Nuclear Medicine therapy team of the Department of Radiology began administering treatment to Reynolds in August 2022.
Within one treatment results were showing.
His first blood tests after the first round of treatment showed the tumors were shrinking in size.
By October 2022, Reynolds was on his third treatment and due to the steady decline in his prostate specific antigen numbers, he had a repeat scan that showed little to no signs of the metastases in his body.
As a part of Reynolds’ involvement in the dosimetry research study, pictures were taken of the distribution of Pluvicto in his body after each treatment.
“The pictures showed high uptake of Pluvicto in his metastases and modest distribution to his kidneys,” said Wong.
“The data he contributed by donating his time for this research has potential to help other patients in a similar situation down the line.”
“Don experienced the extreme end of the positive results we hope for,” Wong continued.
“His response to the treatment is labeled as a complete response since there is no more evidence of the metastases after treatment on his imaging. It doesn’t mean that there is no chance of the metastases returning, but it does mean that the metastases responded as hoped to the treatment.”
By December 2022, Wong had Reynolds undergo one more Pluvicto treatment that he called insurance that all the metastases were gone from Reynolds body.
“I wanted to make sure that there was truly no tumor left, even potentially small metastases that may have been hard to detect on his PET scan,” said Wong.
“But I didn’t want to waste the two treatments he had left in case he needs them in the future.”
For Reynolds, the part of treatment that stood out the most was the minimal side effects.
“I didn’t have any additional fatigue, pains, nausea, or other complications throughout the treatment,” said Reynolds.
“I was able to rest and participate in activities in moderation, something I was unable to do while going through my other treatments.”
Bouncing back a second time
Despite not experiencing many side effects from treatment, Reynolds did experience one effect from treatment that surprised both him and his care team.
After his last treatment, Reynolds was able to go back to his normal activities with monitoring from his oncologist. Within a couple of months though, Reynolds was starting to feel worse again.
“I suddenly started to feel weaker,” said Reynolds.
“I lost color, lost my ability to stay active and felt like I was declining again. It was hard not to fear the worst.”
Lab work revealed that Reynolds’ red blood cell count was extremely low and that he might need a blood transfusion. Within a couple of weeks though, things started to take a turn for the better.
“My oncologist and Dr. Wong were not sure how, but my body started to heal itself and produce more red blood cells,” said Reynolds.
Wong and Reynolds’ oncologist decided to closely observe Reynolds’ red blood cell count to see if his body continued to heal on its own. Within a few weeks, Reynold’s red blood cell count began to recover. He has since had another incident where his red blood cell count has dropped, but each time has been able to make a recovery on his own.
Returning to old hobbies
Through his numerous treatments, Reynolds missed being able to spend time with his family and help his wife, Barb Reynolds, on the farm they own where they grow their own food.
While he has not been able to work at the capacity he used to, he has been able to accomplish more since his final round of Pluvicto treatment.
“I feel like I got a part of my life back,” said Reynolds.
“I know I won’t be able to do my hobbies the way I used to, but it feels good being able to start doing activities I enjoy again even if they look a little different.”
Barb Reynolds has felt firsthand the impact Pluvicto treatments have had on her husband and has seen a positive change over the past year.
“Before his cancer came back in 2018, I relied on him for a lot of help around the farm,” she said.
“Not only did I lose that help on the farm, I felt like I lost a part of Don too. Seeing him become himself again after these treatments has been amazing.”
Reynolds wants to share his experience with Pluvicto in hopes of giving more exposure to the treatment.
“If you have metastatic castration resistant prostate cancer and have the chance to receive Pluvicto treatment, do it,” said Reynolds.
“Beginning new cancer treatments is scary, but I’m thankful that I gave Pluvicto a chance.”