To Provenge or Not to Provenge

[cullenf]

I'm half-way through the Provenge process that my MD Anderson oncologist recommended. I'm wondering what those on this group think about it.

[YostConner]

Without evidence, I’m a Provenge fan.

[cullenf in reply to YostConner]

Thanks for your response. Good luck to you.

[ctarleton]

I had Provenge with UC San Francisco in 2016 after my original PSA dropped from 5,006 to 1.0 and was again climbing back up thru 60 toward 95 as some of my metastatic cancer cells became "castrate" resistant, and while I was still asymptomatic, but with multiple bone mets. I had some symptoms problems with citrate toxicity during each of the 3 hour leukapheresis processes during the first two Provenge cycles, and felt some serious weakness and tiredness and flu-like symptoms (without any of the nasal sneezing or coughing or mucus) within the 24-72 hours after each Provenge infusion. I felt that it probably "took", considering my body's reaction. (I did not do the 3rd cycle due to 2-3 unrelated other medical things that happened at about the same time.) My PSA did not make any big changes at the time, but I would do it again. It may be working enough in the background to make a difference over the longer term. I was offered to go on with a clinical trial involving Yervoy (ipilimumab), or to do either Zytiga or Xtandi next. I elected to start Xtandi 16 months ago and am doing well, with a current PSA of 1.8, and a 4 year 4 month survival, so far. (Largely attributable to some "lucky" cancer cells biology so far, I think.)

[dlestercarlson]

I've had the treatment. I had no problem doing this since it was a fairly simple procedure and the insurance paid for it. Now I'm hoping that it will work in allowing me to live longer.

[ewhite999]

I was treated with Provenge about a year ago. It’s hard to measure its effectiveness but I can’t think of any down side to trying it. I experienced no side effects.

[cullenf in reply to ewhite999]

Thanks! Good luck!

[Cantabrigian51]

I was diagnosed with Gleason 8 prostate cancer in 2009. I had a radical prostatectomy and 4 weeks later my psa was 16. I had a single metastasis in my pelvis. It was radiated, along with the bed of my prostate. One year later I received Provenge, soon after it was approved. I have been on AD3 since then. Last week my psa was .02.

I think Provenge is the only reason I am alive.

[cullenf in reply to Cantabrigian51]

That's great!

[AlanMeyer]

I have seen case reports claiming major benefits of Provenge for men who were still hormone sensitive and had their PSA knocked way down by Lupron or similar drugs.

I'm no expert, and I recognize that case reports don't tell us what typical responses will be. However it makes sense to me that treatments, especially relatively low power treatments, are more likely to be effective against tumors that are already on the ropes. We've seen that both docetaxel and abiraterone have been significantly more effective when given to men who are still hormone sensitive as compared to men who are castration resistant. Overall survival is better with Lupon + Zytiga or Lupron + Taxotere than with one followed by the other. I imagine that the same would be true of Lupron + Provenge.

Unfortunately, our clinical trial system follows the rule that we first give experimental treatments to patients who have exhausted standard therapies. The idea is not to give something that might not work to patients in place of treatments that are working. It makes sense in cases of one or the other - but maybe not so much in cases where we can give both treatments at once, and where we have reason to believe that the first treatment by itself is eventually going to fail.

So, yeah, I think trying Provenge is worthwhile, and especially so if it's not a drug of last resort - where we already know its effects are very limited.

Alan

[Magnus1964]

I went through the provenge treatment a few years ago for some nodules in the lungs. No problems, but I hated that tube sticking out of my chest. The treatment worked well.

[Mathes72 in reply to Magnus1964]

That tube was the worst part,

[sgrama]

My husband just finished his 3rd treatment with Provenge on Thursday. He didn't have not one side effect from it which is great. He hasn't felt any worse or better yet though and we'll see in a couple months when he has his scans done again if anything has changed in his bones or elsewhere in his body. His PSA was 250 on March 28th up from 90 in Feb. and the oncologist wants to start him on chemo again but first we have to wait for at least a month or more to give the Provenge time to do something because the chemo might mess it up is what we were told by the urologist. He started the Provenge treatments on March 15th and I hope the treatment didn't make the raise in his PSA level.