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Patient’s Testimonial: Full Remission after ¹⁷⁷Lu-PSMA therapy

Patient's Testimonial: Full Remission after ¹⁷⁷Lu-PSMA therapy

Here is a testimonial of one of our patients:

"I would like to announce hereby to the world that the small private clinic Minute Medical in Vienna led by Professor Markus Hartenbach, an expert in Nuclear Medicine, is nothing but a giant in helping people in need of medical attention, proving the success of day-to-day practical application of the results of the latest cutting edge scientific medical research.

Dr. Hartenbach had the courage to go against the tide of dusty, stone age “one-size-fits-all-protocols” in the treatment of metastatic prostate cancer, as a humble service to diseased men, who otherwise would have ended up going through depraving and for the human body harmful and often intolerable treatments that would result in the deterioration of the quality of life of people exposed to those treatments.

What are we talking about? The PSMA directed Lutetium-177 ligand therapy for metastatic prostate cancer, which is normally tough or impossible to access. According to my experience, most international doctors follow a “Protocol”, where affected people should rather be exposed to overall abdominal radiation, chemotherapy and years of chemical castration through hormone therapy, which often leads to the building of hormone-resistant cancer cells that cannot be treated any more and the patient is basically left to spend the rest of his life with the spreading cancer in his body. Not to mention the side effects caused by non-focussed radiation, by chemo, not to mention the hardly tolerable effects of hormone therapy.

Prof. Hartenbach is serving his patients by the motto of “individualized, tailor-made treatments”, meaning that he has the courage to apply the suitable most modern treatments at the right time to his patients. As is usual in a private clinic, however these are patients who are striving to receive this treatments at their own cost and possible peril, because they aim to maintain their lifestyle, their ability to enjoy life and their mobility despite their horrible disease, which, to my opinion, under normal “protocol” is made intolerable for the human body, slowly destroying everything in their lives that’s worth living for.

 

I’ve been writing this predominantly in third person till now, to give a somewhat objective report on the case. However, and unfortunately for me, I’m also subjected to this disease, and I went through a long process to find Prof. Hartenbach’s clinic and ask him to treat me. My name is Dr. Sandor Ambrus and I’m 70 years of age.

I can really call myself lucky to have been advised, and therefore being eternally grateful, to my wonderful and widely, as well as deeply, educated family doctor and General Practitioner who is up to date in the latest groundbreaking technologies, Dr. Andrea Szelenyi of Budapest, Hungary, who called my attention to the existence of this special therapy. I am also grateful to Prof. Stefan Förster who is heading up the Bayreuth University Clinic, who could not treat me because of the compulsory “Protocol” in public clinics, that is still controlling the medical practice in Germany. But he was kind enough to introduce me to Prof. Hartenbach and his team, who were able to “tailor-made” adapt the therapeutic approach according to my individual requirements in his above mentioned clinic “Minute Medical” to serve the ones in need with his top-notch treatment.

I had a drastic prostatectomy in January of this year (2024) in Budapest, Hungary, and was diagnosed after the surgery with further lymph nodes that were affected by metastases. I had a PSMA PET Scan that was showing the affected nodes. According to Hungarian “Protocol” – the same as the German one I was advised to go through the above-mentioned treatments, which filled me with a dread that induced sleepless nights, but even worse, horrible nightmares in the night to be awaken by the reality that was even more frightening than those scary dreams. This situation lasted till the moment I met Prof. Hartenbach who encouraged me to have the freedom of choice for my own body.

I had three Lutetium therapies in a row with a month between them. Each treatment took 15 minutes and a pleasant and educational conversation with Prof. Hartenbach regarding my health situation and the outlooks I may have. I have not experienced any side effects whatsoever then and since. After finishing the treatment, I had a repeated PSMA PET Scan that showed the complete remission of the cancer. This may obviously change with time, as you can never know with this disease, but I’m hoping that it would remain like this for a long time. In the worst case scenario that it reappears some time down the line, one can eventually repeat the treatment, depending on the circumstances at the time.

As for my current situation, I live my life to its full extent like before I was diagnosed with the disease. I’m as mobile as I have always been in the past fifty years, working in my business, having a beautiful family life and flying at least once a week within Europe and several times a year overseas. I’m driving tens of thousands of kms a year, and none of this has changed since I made up my mind to see Prof. Hartenbach.

Sincerely,

Dr. Sandor Z. Ambrus"

Transforming cancer from lethal to chronic. Therapy response after 2 cycles (6 sessions) of ¹⁷⁷Lu-PSMA therapy.

Transforming cancer from lethal to chronic. Therapy response after 2 cycles of ¹⁷⁷Lu-PSMA therapy

The case illustrates the scientific findings that the radioligand therapy 177Lu-PSMA is safe and effective and can be successfully applied more than once in case of recurrence, moving towards the goal of transforming cancer from lethal into a chronic disease like any other. It also grants the patients considerably better quality of life than the protracted ADT or chemotherapy.

72 y.o. patient William Daly was first diagnosed with prostate cancer (PC) in December 2021. Despite heavy pre-treatment with several cycles of immunotherapy, cryoablation and leukin therapy, the disease continued to progress extending to lymph nodes. Mr. Daly refused constant antihormonal therapy and chemotherapy due to side effects and opted for 177Lu-PSMA targeted radioligand therapy. The patient has undergone 2 cycles 3 infusions each of the therapy. After the first one, PC went into remission for 1,5 years.

BEFORE 1st cycle AFTER 1st cycle
PSMA PET/CT October 2021

PSA 45 ng/ml.

High PSMA-expressing lymph node metastases.

PSMA PET/CT April 2022

PSA 0,18 ng/ml.

After 3x 177Lu-PSMA therapy sessions from December 2021 to February 2022, significant remission of the retroperitoneal and locoregional lymph node metastases. PSA decline was documented until October 2022 with a Nadir of 2,39ng/ml.

BEFORE 2nd cycle AFTER 2nd cycle
PSMA PET/CT September 2023

PSA 23,3ng/ml

Progressive retroperitoneal lymph node disease with two new bone lesions as well as progression in the prostate.  3-session cycle of 177Lu-PSMA radioligand therapy is repeated 1,5 years after the first one. A short-term complimentary ADT with Relugolix was initiated along with the RLT to increase PSMA expression.

PSMA PET/CT April 2024

PSA 0,1 ng/ml

After 3x 177Lu-PSMA radioligand therapy sessions from December 2023 to February 2024 no activity in the metastases was detected in September 2023. The only side effect reported was short-term mild nausea and mild fatigue after the treatment. Meanwhile the patient stopped all medication and reports general well-being and regained strength.

 

Read Mr. Daly's story in his own words:

"My story began in December 2014 when I was diagnosed with prostate cancer (PC). It was identified as “intermediate risk” with a Gleason score of 7 (3+4) in 3 of the 12 biopsy samples taken. At this point it had not spread, but after an MRI, it showed an “extracapsular extension”. I chose not to have surgery and decided to do watchful waiting. I also wanted to stay away from hormone therapy.

After another MRI, it showed that the PC was very near the seminal vesicles and I engaged a doctor in Fort Lauderdale, Florida to help me with treatment. He performed a 3D mapping biopsy that showed Gleason 8 in the prostate. Then he treated the PC with focal cryoablation, and my PSA went from 9 to 0.6. This was done in October 2017.

The PSA stayed there for about 2 years before it began to gradually move up. As it happens, I was treated for a kidney stone in July of 2020 and a swollen lymph node was noted in my pelvis area. After another MRI, my doctor in Florida suggested that we go through immune therapy. His immune therapy was very successful in some of his patients – but I did not respond to it. It was at that time that we pursued the 177Lu-PSMA treatment with Dr. Hartenbach. First, I had a PSMA scan done in Houston, Texas to see if the treatment could be done at all. After approval, I made arrangements to go through the therapy with Dr. Hartenbach. My PSA was about 48 at that time. That was in the fall of 2021.

After 1 cycle (3 infusions) of the therapy, my PSA was 2.39. The follow-up PSMA scan showed a remarkable improvement. There were only a couple of places where the cancer was still in the process of dying. We were very pleased at the response. This was in the spring of 2022 and the therapy had given me 2 years of remission. After closely monitoring the PC with scheduled labs, the PSA began to move up again. When it reached 23, we felt more treatment would be beneficial.

So, in December of 2023 I started another cycle of the 177Lu-PSMA  therapy. We also added a drug called Orgovyx to the therapy. The PSMA scan was done in April after the treatment was completed in February 2024. I guess I can say that I experienced  minimal side effects from the treatment (some nausea for a couple of days and some “dry mouth”). So, all in all, I was treated with 2 cycles (6 actual infusions) by Dr. Hartenbach.

This time, the results of the treatment and scan were remarkable. The PSMA scan was clear and the report said I had a “complete response” to the therapy – my PSA is now 0.1. This couldn’t have been a better result and I was so grateful and blessed to have been working with Dr. Hartenbach and his staff. I am praying for a long - term remission.

Thanks again for Dr. Hartenbach and all his staff."

“This treatment has given me back my life.”

"This treatment has given me back my life."

Success story after 3 sessions of radioligand PSMA therapy with 1x Actinium-225 & 2x Lutetium-177

Sean Kenny was first diagnosed with prostate cancer in December 2020, when he just turned 51 y.o. Before landing in our clinic, he had undergone multiple treatments, including 6x Docetaxel, antihormonal therapy, immunotherapy and cryotherapy. He chose to pause ADT due to side effects but had to re-induct antihormonal therapy with Firmagon and Apalutamide mid-2023. The cancer was still progressing with an increasing bone involvement. Despite PSA response, pain and PSMA expression persisted. He was put on morphine medication for pain relief. His left hip was so badly damaged that it had to be replaced. After 3 years of back-and-forth Sean opted for PSMA targeted radioligand therapy (RLT) and experienced a remarkable recovery following just one 3-session cycle. Due to heavy bone infiltration, we recommended the first session be done with Actinium-225 and the two remaining - with Lutetium-177. Judge for yourself.

BEFORE

PSMA PET/CT December 2023

PSA 2 ng/ml after re-induction antihormonal and ARPI treatment. St.p. hip replacement to the left previously. Still high PSMA expressing bone metastases and pain under morphine medication.

AFTER

PSMA PET/CT April 2024

After 1x 225Ac and 2x 177Lu PSMA ligand therapy sessions from December 2023 to March 2024.

PSA 0,18 ng/ml. Minimal residual activity in the known bone lesions, most likely apoptotic cells. ALP down from 570U/l to 180U/l (norm <150).

Sean experienced pain relief 10 days after the 1st RLT session with Actinium-225 PSMA and was able to get off the morphine medication. Hemoglobin and kidney values normalized after the 2nd RLT session with Lutetium-177 PSMA. The only side effect he experienced was short-term mild nausea and mild fatigue after the treatment. At the time-point of the control PSMA PET/CT, these symptoms were gone. Sean reports general well-being and regained strength.

Here is the story in his own words:

"My story started back in December of 2020 when I was told that I had advanced prostate cancer, which had spread to my lymphatic system. This was picked up with a routine blood test when I turned 50 years of age and when they included the PSA as a blood marker. I did not have any obvious symptoms at the time and in fact I was still running 7-minute miles and was very active.

I was put on hormone treatment in January of 2021 after I came back from the Royal Marsden hospital in the UK where I got a PSMA scan (I could not get a scan in Ireland for 9 months). Later in 2021 I started a course of 6 x Chemo (Docetaxel) and then 4 weeks of RT. In early 2022 I came off the hormone treatment due to side effects (my PSA has gone to a very low figure). I got my life back again as I regained my energy, and my fatigue was a lot less.

Then in early 2023 my PSA started to slowly rise again, so we looked into travelling to the US to undergo immunotherapy and cryotherapy at a clinic. While waiting for this clinic to admit me I developed an intermittent pain in my left leg which I relayed to my oncologist during an outpatient visit. After immediate X-rays of my leg, I was told that I had an impending fracture of my femur and needed an emergency hip replacement (my pelvic bone was also diseased). My hip was replaced 2 days later, and when I was strong enough again, I went to America to undergo this procedure in the hope that it would put me into remission again. Unfortunately, this operation was not successful, and within a month of coming home the pain I was suffering in my leg area was unbearable due to the metastasis in my pelvic area. I was put straight back on hormone treatment again and was told that I would be also receiving RT again.

My good Wife Brid had been in touch with the American clinic looking to see if there were other options available. This was then when I was referred to Prof Hartenbach and the rest as they say is history. I’m off all pain medication and with the hopes of coming off both my hormone treatments in the near future. From there it will be active surveillance and fingers crossed, but certainly this treatment has given me back my life. 

Thank you, Prof. Hartenbach and team."

 

Interview with a patient

 

The patient A.G., 72 y.o., a molecular biologist himself, was diagnosed with metastatic prostate cancer in September 2018. After the conventional standard-of-care treatment (chemo- and antihormonal therapy) there were still residues of the primary tumour in the prostate, and lymph nodes and bone metastases. Up to date he has gone through 9 sessions (3 cycles) of 177Lu-PSMA therapy in the course of three years, initiating a new cycle once a routine control 68Ga-PSMA PET/CT detected PSMA expressing cancer lesions. The therapy has been extremely successful for A.G.: high response and hardly any side effects. Targeted radioligand therapy brings us much closer to the goal of making prostate cancer just another treatable chronic disease, at the same time preserving a decent quality of life, much like e.g. diabetes.