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Zachary Klaassen: Hi, my name is Zach Klaassen. I'm a urologic oncologist at the Georgia Cancer Center in Augusta, Georgia. I am really pleased to be joined on UroToday by Mr. Jim Wasielewski, who was the first patient to receive Pluvicto in the FDA new approval pre-chemotherapy for mCRPC. Jim, on behalf of everybody at UroToday and the Prostate Cancer Foundation, thank you so much for joining us today.

James Wasielewski: Thank you for having me here.

Zachary Klaassen: So I really want to just get into just the nuts and bolts. This was right after the FDA approval on March 28. He received the first dose on April 3. How did the conversation go with you and Dr. Finkelstein about moving forward with lutetium radioligand therapy immediately after this approval came through?

James Wasielewski: OK, well, we talked about it the week prior to that, or even maybe even prior to that, because I had options. My PSA, after being on the Lupron and Xtandi and things like that, my PSA started rising again.

Zachary Klaassen: Yeah.

James Wasielewski: So we said, OK, what are the other options? Chemo, which I wasn't crazy about. Radiation was available. Both those are pretty drastic, and they can do a real number on your body.

So this was a targeted—this was a targeted therapy. So this is what I opted for. And he said—we anticipate them getting approval for the Pluvicto medication next week. He said, are you ready to go? And I said yes.

And then on Monday, he called about 3:00 and said, hey, the FDA approved it. We're ready to go. Are you? And I said, yes. He said, OK, we're going to put everything in motion. And I figured it would take a week or two or maybe two weeks. You never know with insurance and everything else.

Zachary Klaassen: Sure.

James Wasielewski: Then he calls me on Tuesday and says, OK, get ready to fly. We're going to be there. Come in at 7:30 in the morning in Syracuse. And we're going to start the process. And I said, OK. And that was it. There were amazing hoops they had to jump through, but they made it happen.

Zachary Klaassen: That's awesome. And I just want to lead into that 3rd. So this was April 3rd, so this is literally six days after the FDA approved it on Friday, March 28. Just tell us a little bit about that whole day. How did it go?

James Wasielewski: Well, other than me having to get up early, it went pretty good. But when I got there, the whole team was assembled. They had the hot rooms set up with the coverings over the chairs and everything else.

And they had a team there—the nurses, the Novartis guys, the guys with the Geiger counters and the serum. They gave me two—what he did is he gave me two ports, one in one arm, and one in the other arm. One was a backup, just in case the Pluvicto didn't go through. He wanted to make sure that there was a secondary option. But that worked out fine. Didn’t need that.

And so it just was 10 minutes. Maybe not even that. It was like a blur. Really, with all the people around there, I felt like a rock star. I said, wow! All these people catering to me.

Yeah, I said, man, I feel like the Rolling Stones, Mick Jagger. I said, I don't even get this much attention from my wife.

Zachary Klaassen: That's great. I think when you look back over the last month or so, what does it mean to you and your family? You mentioned not really wanting to go through chemo. What does it mean to be able to receive this in the pre-chemotherapy space to you and your family?

James Wasielewski: Oh, I think it’s—it's fantastic. I've been very active, even though I had the prostate removed 25 years ago. And I've been on Lupron, and I've had the immunotherapy. Had that.

Then we went to the Xtandi. I’ve been on Xtandi for seven years, and that's kept everything tamped down. And it's enabled me to have a good life, good, active life, which I wanted.

Then it started increasing again, so we knew we had to do something. And I knew if I went on chemo, that could really drastically curtail the activities and stuff that I was going to be doing.

And I feel great. We had the injection on Thursday. On Friday, I went for a little two-mile walk. On Monday—or, yeah, no. On Sunday, I went for a three-mile walk. Wednesday, I did a four-mile walk. Tomorrow I'm planning on doing a five-mile walk. And I'm getting ready for hiking season and kayaking season and stuff.

And also, what it means also is that not only that, but I never thought I'd be able to see my—reach my 50th wedding anniversary. Last month, we celebrated our 60th wedding anniversary.

Never thought I'd be able to see my grandchildren graduate from high school. One's in grad school, two are in college. One will be starting college. It's just fantastic. It's giving—I've been truly blessed. That's all I can say.

Zachary Klaassen: No, it's such a great message. And congratulations on the 60th wedding anniversary.

James Wasielewski: Thank you.

Zachary Klaassen: Grandkids going through college now and post grad school. So for the physicians out there that are listening to our conversations, what would you say to them specifically about considering therapy for their mCRPC patients in the pre-chemotherapy space?

James Wasielewski: Recommend it quickly, as soon as possible. Get it while the—because I've gone on the internet. And there's a lot of reviews from the pre-trials and trials like that. And most of the people, if you get it earlier, they have better results.

So I wouldn't hesitate. If you can get the insurance companies and Medicare or whoever’s doing that, push them to the limit. Get them. And try to impress on your patients the difference between being an active participant in life and having a good quality of life rather than just sitting around and watching life go by.

Zachary Klaassen: Yeah, awesome message. And similarly for the patients out there that are listening to us, what would you say to them in terms of your experience? And you kind of went through it a little bit already, but they're considering Pluvicto before chemotherapy. What would you say to them?

James Wasielewski: I'd say go for it. Obviously, it's only been a week, so I really don't know what the long-term effects are. But right now, it’s been super. As I said, I’ve got little taste discrepancies there on the salt and sugar.

Zachary Klaassen: Sure.

James Wasielewski: But other than that, my energy level is still good. And yeah, by all means, encourage your doctor to put you on this thing. Fight for it, you know?

Zachary Klaassen: Absolutely. Jim, I think it's been such—this is such good information. We do a lot of peer-to-peer, physician-to-physician conversations on UroToday. But this is so helpful because the patients really want to hear from people going through it like yourself. And congratulations again on all the success. 25-plus-year survivor of prostate cancer. And I can't thank you enough for your time on UroToday.

James Wasielewski: Zach, thank you very much. It's been a pleasure to be here. And I'm the beneficiary of all the people who have been on trials, have been through chemo, and all those other things. So I'm very blessed that maybe 20 years ago I wouldn't be here, or 10 years ago I wouldn't be here. But those are the real heroes, the real people that have paved the way for us.

Zachary Klaassen: Yeah. Fabulously said, and thank you again for your time.

James Wasielewski: Thank you, Zach. Good seeing you. Nice meeting you.