Provenge

[Apollo123]

Hi All I am continually asking you all questions but I’m learning so much. I have seen a few members discuss Provenge as I treatment, I have googled it extensively! When is the best time to use this treatment? Can I suggest it is used whilst I am on Zytiga and have a low PSA 0.1 or do you wait until later? Can it attack and destroy the cancer as it lays dormant. Has anyone had this treatment in the UK or is it only available in the America. Thank you all again. 👍

[YostConner]

Apollo, I can't answer all your questions, but I can tell you that when I did Provenge in the fall of 2014, I fit the parameters outlined on their website: rising PSA on ADT, metastatic disease and not using narcotics. A few weeks later, I started Zytiga. Although it's not possible to confirm that Provenge helps any particular individual, my family and I believe it provided a good environment for Zytiga to work so long.

[Caring7 in reply to YostConner]

That was our experience too. The key thing for Provenge is that you cannot have visceral metastasis (in your organs). Bone is OK and also lymph nodes (I think). Our theory, like Yost's, is that it was hard to tell exactly that the Provenge worked, but the Provenge (and the RA223/Xofigo and the early chemo) -- we *think* all came together and gave my husband two pretty awesome years (so far) on Xtandi (we opted for Xtandi first over Zytiga).

Oddly -- per Yost's comment about narcotics - we were worried they would deny my husband because he was "too healthy" but they initially denied because as "too sick" because they saw the occasional narcotic use for spine tumors. We were able to straighten that out.

Amazingly, the treatment was available here in Hawai`i so I hope it is available to you in the UK. Most of the info on it does come straight from the Provenge people . . . It's a tedious process but generally went OK for my husband. He did fine for first two treatments. I went off to Australia for #3 and he got the flu-like symptons (of course!). He was OK just felt like a very bad flu (went to ER for workup to make sure not sepsis or something else, and fluids).

Our recommendation is to try it in the window between becoming castration resistant and things getting too far along.

[Hidden]

Here's a recent article about Provenge:

dddmag.com/news/2017/06/asc...

And a quote from the article:

“We are pleased that these data confirm the mechanism of action of PROVENGE and its effect on overall survival. This survival benefit has been demonstrated in both controlled clinical trials and in our PROCEED registry,” said James Caggiano, president of Dendreon. “PROVENGE remains the only cellular immunotherapy approved by the FDA for advanced prostate cancer and has been proven to extend life with a generally manageable safety profile. We look forward to seeing it used to help more men with advanced prostate cancer.”

Treatment with PROVENGE induces a patient’s immune system to generate a response to both PA2024 and PAP.i To assess the mechanism of action by which PROVENGE induces an immune response to both PA2024 and PAP, Dr. Drake and other investigators analyzed blood samples from 15 patients who participated in three PROVENGE clinical trials (STAND, STRIDE and STAMP).

In the pivotal Phase III trial, PROVENGE showed a statistically significant OS advantage, with an increase in median overall survival by 4.1 months and reduced the relative risk of death by 22.5 percent. The results evaluated in this study showed a sustained increase in PAP and PA2024-specific killer (CD8+) T cells responses after treatment.i This immune response was maintained through week 26.iAdditionally, OS data were available from the STAMP study, and an improved OS was shown to be strongly associated with PAP- and PA2024-specific killer T cells in patients in that study.i At 26 weeks, a strong positive correlation was observed between improved OS and PAP- and PA2024-specific memory response for killer T cells.i Patients in the STAMP trial who had a killer T-cell response above the median had markedly longer OS than patients with a response below the median, and OS was significantly longer in patients with responses above the median at week 26.

[Hidden]

My Mo told me that my psa needs to be 2.0 and rising. It is best administered when when a psa is under 20. My insurance, Medicare and Blue cross would ok it unless my psa is 2.0 and rising. Of course what do they know? Oh, I'm in the USA.

[Olivia007]

My dad had it done he has a gleason 9 and cancer mets to bone. Xgeva and lupron shots every month they controlled it for a year then Dr. suggested Provange and we did that then his PSA was still on rise was put on xtandi for about 3 weeks and PSA went down too low which was great so dr took him off xtandi (pills) and we still do shots monthly and check PSA so far PSA is low and dad is in remission. Thank GOD

[Olivia007]

Also sorry to mention we are from the USA. Hopefully it will come to you but if not and you have the time and money I would try anything. Bless you!!!

[JoelT]

At this time it is only available in the US. The current owner's of Dendreon are located in China and it is my understanding that they are planning on expanding its availability in Asia. Prior to their economic problems, they had been working towards expansion into Europe, but I am not aware that this is still an immediate target.

The best time to use Provenge is when there is minimal disease burden. The earlier it is used the changes of gaining from the treatment is increased.

Do not expect to see your PSA go down when you use Provenge. Most likely it will continue to rise and scans will also show progression. This is OK, Provenge is a different type of treatment then ADT or chemo, its mode of action is different.

Once you have completed Provenge you can freely move on to another treatment.

Joel

[Hidden]

Provenge currently requires a rising PSA. So if you are starting a new treatment (that may affect PSA) better timing is to do Provenge before that other treatment, otherwise you may become ineligible for Provenge. If you do Provenge, then do continue right away with whatever else you were planning. Don't delay and say - let's see what happens. Think of Provenge is a "background" treatment.

There has been a claim, that the main Provenge trial was flawed - the flaw being that the people in the placebo arm did get their white cells extracted, and it is not clear how viable those cells were when one third of them were re-infused - the other 2/3 saved for "Frovenge" if the patient chose to "cross over". So the worry is that the placebo arm did actual harm (to those over 65 with impaired ability to regenerate white cells), and the treatment arm looked good by comparison to those harmed. You can google this if you care to. Dr Drake has dismissed this concern, I hear. Provenge is not a CAR-T therapy. [ I have received Provenge. I have talked to one patient who enthusiastically swore that Provenge "saved his life", at PCRI 2016.]

ncbi.nlm.nih.gov/pmc/articl...

[Magnus1964]

I was took the Provenge protocol about 3 years ago. Some nodules showed up in my lungs. Not a bad experience. The Patient Network Access program paid for the treatments. The whole program takes about 6 weeks. I was fortunate that the nearest Red Cross Center that would extract my white blood cells was only about 25 miles away. I used a car service to take me back and forth, also paid for by the PAN. The infused white blood cell were reintroduced at my doctors office. The nodules disappeared. I went on Aboraterone after Provenge because of a rise in PSA.

[Shepard]

I completed my second round of white cell collection and reinfusion this week. Will complete the third and final in two weeks. My doctor suggested the Provenge after PSA rose from 0.0 to 4.3 and mets found in lymph nodes. These two events seem to be the qualification in my arena. So far I have tolerated the process well. Benefits are not evident for me at this early stage. I have been told that I will need chemo in the near future and that this therapy will make it more effective. Good journey to you.

[DenDoc]

I will be starting Provenge soon. My pulmonary mets have become symptomatic and my PSA is rising, now at 3.0. My oncologist suggested we try Provenge now before starting on Xtandi which can be added when needed. I have been on Lupron for 8 1/2 years with little change until this year when the pulmonary nodes grew and I have a mild effusion(fluid) in the left lung. My summary is in my profile.

I have Kaiser Medicare Advantage with an out of pocket cap of $2500 this year. Next year it doubles to $4900 so we will get it done by year end.