“I knew if this treatment was going to help me, I would drive wherever to get it.”
Living in Cadillac, David Levine was an avid hunter and outdoorsman who thrived on adventure. About 15 years ago, his active lifestyle was unexpectedly interrupted after a routine visit to his primary care physician. His routine bloodwork revealed elevated PSA (prostate-specific antigen) levels - a potential sign of prostate cancer. Though he had no apparent symptoms, Levine continued regular visits with his doctor until he was referred to Karmanos Cancer Institute at McLaren Central Michigan, Morey Cancer Center in Mount Pleasant for further evaluation.
Levine underwent additional bloodwork and a biopsy to confirm the diagnosis. The biopsy showed an adenocarcinoma with a Gleason score of seven. He was diagnosed with an aggressive metastatic prostate cancer.
After careful assessment and discussions with his health care team at Karmanos, Levine began radiation treatments. His treatment plan also included Lupron, a medication used to treat hormone-sensitive conditions by suppressing testosterone production in the body. This combination caused only minor side effects, such as night sweats and hot flashes, but proved effective in slowing the progression of the prostate cancer and reducing his PSA levels.
After a few months, his PSA levels began to rise again. He underwent several rounds of additional androgen deprivation therapy, but there was only moderate progress in his levels. His dedicated nurse practitioner, who closely followed his progress, advocated for a newly FDA-approved treatment called Pluvicto® (lutetium Lu 177 vipivotide tetraxetan).
Access to a New Therapy
Pluvicto is a radiopharmaceutical therapy (RPT). RPTs target metastasized tumors at the cellular level, reducing radiation exposure to normal, healthy tissue and reducing significant side effects.
“RPT uses radioisotope therapy in the process of delivering radiation intravenously to cancer cells by adding radioactive material, or radionuclides, to proteins that bind with the receptors on the cancer cells, destroying those cells,” explained Nitin Vaishampayan, M.D., Levine’s radiation oncologist, medical director of Radiopharmaceutical Services and interim leader of the Genitourinary Oncology Multidisciplinary Team at the Barbara Ann Karmanos Cancer Institute in Detroit.
Since 2017, Karmanos has been a pioneer in Michigan in using RPTs. Dr. Vaishampayan was a co-investigator in the nationwide VISION phase III clinical trial that studied the use of Pluvicto to target prostate cancer cells in male patients with advanced metastatic disease that was no longer responding to hormone therapy. Studies have shown that Pluvicto can prolong radiographic progression-free survival (the time before progression is detected on imaging) and lead to an overall survival advantage compared to standard care. This study led to the FDA approval of Pluvicto in 2022. To date, Karmanos has provided well over 800 RPT infusions. Over 250 of those infusions were Pluvicto, given to patients after its FDA approval.
The nearest Pluvicto treatment location was at Karmanos Cancer Center in Detroit, where Dr. Vaishampayan practices. During a virtual consultation, Dr. Vaishampayan carefully reviewed Levine’s case and determined that he was not yet a candidate for Pluvicto, as his PSA levels were decreasing on his current treatment at the time of the consultation.
After several more months of monitoring, his PSA levels climbed again, this time to 60. Additionally, Levine had a PET PSMA (prostate-specific membrane antigen) scan that showed progression of disease. His new primary oncologist at Karmanos Cancer Institute in Mount Pleasant, Elias Zeine, M.D., hematologist and medical oncologist, revisited the option of Pluvicto. Dr. Zeine explained the treatment process in detail. After reevaluation with Dr. Vaishampayan, it was recommended that Levine proceed with this course of therapy.
This is what Karmanos refers to as the Karmanos Advantage. Oncologists at the headquarters in Detroit work with hundreds of doctors to arrange convenient care for patients and their families. Physicians in Detroit, Dearborn, Farmington Hills, Roseville, and Maumee, Ohio, as well as those practicing at the additional 13 Karmanos locations located near a McLaren Health Care hospital (also known as the Karmanos Cancer Network), work together to recommend the best options with immediate access to the latest cancer-fighting drugs and therapies.
“Being part of the Network, patients who are seen at the Karmanos locations outside of Detroit have access to unique treatments, newly FDA-approved therapies, and clinical trials that, for the time being, are only available at the Detroit cancer center. It’s like having early access to care,” said Dr. Zeine. “Our colleagues in Detroit are only a phone call away. As oncologists in the Network, we have collaborative access to review cases with physicians in Detroit to discuss the course of action for any patient we see who may require care that we do not currently offer here. This ensures every cancer patient gets their best chance with Karmanos and McLaren.”
Making the Drive for A Better Outcome
During his cancer journey, a woman he shared a special bond with that began decades ago came back into his life. During their 50th class reunion, he reconnected with Connie. She accompanied Levine on the six-hour round-trip drive to Detroit to receive his first Pluvicto infusion and has stood by his side every step of the way.
“I knew if this treatment was going to help me, I would drive wherever to get it,” he expressed.
“When treated with Pluvicto, patients receive outpatient treatment every six weeks for a maximum of six infusions. Appointment times are usually less than one hour,” Dr. Vaishampayan explained.
After his first treatment in November 2024, Levine’s PSA level dropped by close to 50%. Dr. Zeine was pleased that just a single treatment had lowered his PSA to 30.
Levine had to avoid close contact with others for the next three days, but he experienced no side effects.
“I was not nauseous. I could eat whatever I wanted to. It was manageable. I felt like myself - I could do anything I wanted,” he recalled.
Each of his appointments lasted about 60 to 90 minutes. In fact, the drive from Cadillac to Detroit often took longer than the Pluvicto treatment itself.
“The staff at Karmanos was superb, and I have no complaints about the care I received there,” Levine said.
Six weeks later, Levine returned to Karmanos in Detroit for his second Pluvicto treatment, which resulted in another 50% reduction in his PSA level. Following his third treatment, his PSA levels dropped by yet another 50%. When he completed all six Pluvicto treatments in July 2025, his PSA level had returned to a normal level of 2.
New cancer treatment options often come with uncertainty and concern, but Levine had a different outlook.
“If I liked my doctor, I trusted my doctor,” he said. “I was willing to do what Dr. Zeine recommended, and I’m so glad I did - because it truly helped me.”
After completing his final Pluvicto treatment, he married his partner and faithful companion, Connie, on May 17, 2025. Now at 78 years old, Levine is embracing life to the fullest, where he can do whatever he wants, as long as he’s by the side of his beloved wife.
When asked what advice he would give to others considering Pluvicto, Levine shared, “If other treatments are not working, consider Pluvicto. I did not experience any side effects from it. Trust your doctors - they know what option is best for you.”
Advancing FDA-Approved Therapies
Under Dr. Nitin Vaishampayan, Karmanos was one of only 18 international sites in the phase III study and enrolled 29 patients. Karmanos was among the first in the world to receive this treatment and ranked as one of the highest accruing institutions. During the FDA inspection that followed at Karmanos, the agency reported minimal findings, a testament to the precision and integrity of the clinical trials team and clinicians involved. This work contributed to the development of a new life-extending therapy and reinforced Karmanos’ standing as a leader in high-impact, industry-sponsored research.
If you or someone you know is battling metastatic prostate cancer and wondering if Pluvicto may be the next step in treatment options for you, call 1-800-KARMANOS or visit karmanos.org.