Provenge (only) - impact on overall survival

[Gl448]

I just got insurance approval for Provenge...out of pocket is really high so now I'm doing a cost benefit analysis in my mind.

I've seen many different articles showing that Provenge ALONE only extends overall survival by 4-15 months. Does that sound correct?

Tall_Allen mentioned adding xofigio for better results, but I haven't had a chance to discuss xofigo with my doctor yet.

I'm on triplet therapy, chemo part finished last May. Became mCRPC last September. Latest PSA was 0.918, but PSA is not good indicator for me, highest it got during cancer was 1.1

Any thoughts from Allen or the group?

(My profile history needed updating so it's blank right now while I edit it down to make details easy to read.)

[Tall_Allen]

I think it works best with at least some kind of radiation - radiopharmaceutical or SBRT to metastases.

I would quibble with your use of the term only in "only extends overall survival by 4-15 months." How much do you think all the other approved medicines extend survival in mCRPC?

[Gl448 in reply to Tall_Allen]

That's a good quibble.

I'm getting a fresh PET next month, so maybe they'll find some SBRT candidates. I consulted with an RO last week to zap a painful hip met, but the last scan was in September, and the RO wanted something newer when I pointed out some bone pain in the clavicle.

Thanks.

[Schwah]

I did Provenge last year. I’m hormone sensitive so insurance wouldn't pay. But I did a lot of research and talked to a lot people and concluded it was worthwhile to pay out of pocket. Here was some of what i learned.

First, your 4-15 month survival numbers are “median survival”. Not average. Meaning that an equal number of people survived longer and shorter than those numbers. This means if 10 people lived 3 months and 10 people lived 3 years then the median survival is 3 months. You could be one of the lucky ones and theres no indication it might hurt you in any major way

Secondly, when you take a longer look at the data and break it into tranches by PSA reading at time of treatment, the lower the PSA at the time of treatment, the better the survival number. Therefore, in your case, with a much lower PSA than the typical man doing provenge, your odds of longer survival should go way up.

Thirdly, TA as usual is right. The indications are that combining Provenge with radiation will have a synergistic affect and thus better results. For that reason, I did SBRT to a known met on L-5 concurrently with my Provenge.

Finally, the side affects are very minimal and i liked the idea of helping my body’s immune system fight the beast.

good luck with whatever you choose.

Schwah

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My MO used this approach: When my PSA started rising, I went through Provenge followed by Zytiga 30 days later, That was 52 months ago. I'm still on Zytiga and still undetectable,