Provenge Combo with Enzalutamide

[Danielgreer]

Not sure if this has been posted yet. Provenge in combo with Enzalutamide reduces risk of death by 45%. Median OS is 14.5 months vs. just 4 months with Provenge alone (This is what I recall, please tell me if it is significantly different).

urotoday.com/conference-hig...

[BruceSF]

As I read it, provenge increased median os from 20 months to 34.5 to yield the 14.5 month effect. It is a retrospective study, so it is possible that there were other differences the treatment than just the provenge - i.e., the places that offered provenge had a higher overall standard of care. However, it is a pretty strong result, so if you have mCRPC it’s probably worth the effort if insurance covers it.

[Danielgreer in reply to BruceSF]

Hi Bruce, My MO is recommending this for me as a possible next step. I was diagnosed with widespread metastatic pc right off the bat about a year ago and my MO put me on ADT and Darolutamide. I’m still hormone sensitive but I asked her about next steps and she said I could stay on my current meds and add Provenge once I become resistant. I also read that Xofigo works pretty well after therapy with Provenge. Hopefully I’ll stay sensitive for a while longer but it’s good to know there’s something that could help further on down the road.

[BruceSF in reply to Danielgreer]

Yes, the immune therapies seem to do better when combined with some sort of radiation. There's actually a trial underway for adding keytruda to xofigo (NCT03093428) and I hope they report in the next year or two. Also there was a report at the Feb 2020 ASCO GU conference that had 'mixed results' from the combo (onclive.com/publications/gu... so hopefully we'll know more before either one of us needs it!

Bruce