1st post. 1st line of tx ending? Looking into next best step.

[Ramblingon]

I have read, and learned, and thought about much thru this site. We are investigating new line of treatment and would appreciate any new lines to follow. Are scheduled for PSMA PET 3/21 and want to be informed before MO appoint 3/24. Depending on scan results options seem to be 1) if 1 spot radiate, 2) start chemo 3) possibility of PSMA FORE trial once PSA reaches 2 but would involve 4hr drive 1 way, many times. Wonder when is best time to try Provenge. Any other txs? Should we look into 2nd consult? Any recommendations for consult- we live in southeast Indiana?

Thank You.

[Schwah]

I can answer one of your questions regarding the best time do use Provenge. I spent a lot of time with my doctor investigating earlier use of Provenge snd concluded that like most treatments it works better the earlier you use it. . Specifically, when one looks at the phase 3 Provenge study, overall, the median Extension of life was only about 4 months. However, they actually broke the study into a number of different starting PSA levels. It showed that the lower the starting level of PSA, the greater the difference in median life extension was vs placebo for men with the same starting PSA levels. And in fact at the lowest starting PSA group (under 10 I believe) the difference was over 14 months. I’m still hormone sensitive with a PSA that went up to about 4.5 while on a “vacation”. Based upon my research I decided to do Provenge now. I had to pay out of pocket which was stupid high, but as they say, Hearst’s have no luggage racks.

Schwah

[Ramblingon in reply to Schwah]

Thank you Schwah for your response. The breakdown of better response at lower PSA is encouraging. I will look into the study. The timing of what to do when, what order, or what together for best response is important.

[CAMPSOUPS in reply to Schwah]

Thanks Schawah.If you have the study name or I might ask: Do you recall if the cohorts were various in treatment progressions? From newly dx'd to a few treatments under their belts?

In other words low PSA in newly dx'd or low PSA no matter prior treatments?

[ishitasen]

The best time to try provenge is when the disease burden is small.

[Ramblingon in reply to ishitasen]

Thank you for your reply. We are currently doing docetaxel tx, 2 of 6 sessions done. The psma pet showed 5 lesions, all on spine. PSA went from 1.4 prior to 1st tx to 2.04 prior to 2nd which concerns us but MO said to be expected. I am wondering if we should try Provenge after the 6 txs to build fighter cells for possible LU 177 in future?

[ishitasen in reply to Ramblingon]

Ideally u should use provenge after lu177 psma to sustain the response

[CurrentSEO in reply to ishitasen]

Hi Ishita, what is your opinion on Indian APCEDEN vs Provenge efficacy?

[Ramblingon]

Thank you for your reply. I'm sorry but I wasn't clear on the bio. We have never been on a med vacation. He had continued Lupron, Zytiga and prednisone throughout. He has now stopped Zytiga and started docetaxel tx. We continue to learn

[Ramblingon]

I apologize Nalakrats. I just noticed you were replying to Schwah. I am still learning how to use this site. Thanks