Had my first leukapheresis done Friday, then had my first re-infusion with Provenge yesterday.
So far so good. No side effects yet.
The only snag so far is when the transportation to Orlando for leukapheresis (provided by Provenge manufacturer) hit a snag, and a different transportation had to be found. But it all came together.
2 more rounds to go.
you are not on any ARSi ?
No, I've never been.
why did you do Provenge before ARSi ? Just trying to understand 😊
I qualified, it only takes three treatments, few side effects, supposedly extends life, AND doesn't conflict with any other treatment. So I can still do everything else.
Everything I read is that it works best the earlier one does it. The problem with jumping to another hormonal is that it would have pushed Provenge back to where it might not work as well. I decided best to do it now, then decide where I want to go from there.
It sounds like the decision to do Provenge (sipuleucel-T) before an androgen receptor signaling inhibitor (ARSi) was based on several key factors:
1. Provenge is most effective earlier: Provenge is generally believed to work better when administered earlier in the course of treatment for metastatic castration-resistant prostate cancer (mCRPC), before the disease becomes more advanced or heavily treated with other therapies.
2. Minimal side effects: Provenge involves only three treatments and has relatively few side effects, making it an attractive option to start with while keeping other treatment options open.
3. Doesn’t conflict with other treatments: Provenge doesn’t interfere with other treatments, allowing patients to proceed with additional therapies like ARSi (e.g., Enzalutamide or Abiraterone) afterward.
4. Avoid delaying Provenge: Starting with an ARSi could have delayed Provenge until a time when it might not be as effective. Since Provenge is an immunotherapy designed to stimulate the body’s immune system to fight cancer, the idea was to administer it early to take full advantage of its potential benefits.
This approach allows for Provenge to be integrated into the overall treatment plan without sacrificing other options later on.
Thanks. But why are more men not getting it then
I live in Australia and I would need to pay lots of money out of my pocket what I don't have. Plus my medical oncologist did not recommend it because it does not reduce the psa.
Here in India also I don’t see it recommended though we have pluvicto and actinium here now
I am now thinking to go to India and get the Indian version of the immunotherapy vaccine or something like that.
What’s it called ? If you need any help do let me know 😊
Thanks. TA knows more about the the Indian version. Ask him if you are interested by being there?
Tall_Allen can you please tell me the name of the Indian immunotherapy vaccine
Yes, India does have a form of immunotherapy vaccine for prostate cancer called APCEDEN®. It is developed by the Indian biotechnology company APAC Biotech and is an autologous dendritic cell-based cancer immunotherapy, similar in concept to Provenge (sipuleucel-T).
Key points about APCEDEN®:
1. Personalized treatment: Like Provenge, APCEDEN® is made using a patient's own immune cells (dendritic cells) that are collected and re-engineered to stimulate the immune system to target prostate cancer cells.
2. Treatment process: The process involves extracting monocytes (a type of white blood cell) from the patient, cultivating them into dendritic cells, and then exposing them to prostate cancer antigens. These primed cells are then infused back into the patient to stimulate the immune system to fight the cancer.
3. Approval and use: APCEDEN® has been approved for use in India in treating various cancers, including prostate cancer, and is considered an advanced option for patients in the late stages of the disease.
4. Availability: APCEDEN® is available in certain medical centers and is offered as a treatment for metastatic prostate cancer patients in India.
While it is not exactly the same as Provenge, APCEDEN® follows a similar approach of leveraging the patient's immune system to target prostate cancer and represents a significant advancement in cancer treatment within India.
APCEDEN®, the Indian autologous dendritic cell-based vaccine for cancer, including prostate cancer, is available in certain specialized cancer centers across India. It is developed by APAC Biotech and has been approved by the Drug Controller General of India (DCGI) for treating specific types of cancer, including metastatic prostate cancer.
Availability:
APCEDEN® is offered primarily in larger, specialized hospitals and cancer treatment centers across India. Patients interested in the treatment will typically need to consult with oncologists at these centers to determine if they are eligible for the therapy.
The treatment is personalized, and it involves a multi-step process that can only be performed in centers equipped to handle advanced immunotherapy procedures.
Treatment Process:
1. Patient evaluation: The treatment begins with the collection of the patient's blood to isolate monocytes (a type of immune cell).
2. Dendritic cell production: These cells are then cultured in a laboratory and exposed to cancer antigens to "train" them to recognize and fight cancer cells.
3. Infusion back into the patient: Once prepared, the primed dendritic cells are re-infused into the patient to stimulate the immune system to attack the cancer cells.
Cost:
The cost of APCEDEN® is typically quite high, ranging from ₹4-5 lakh (400,000–500,000 INR) per dose, and patients usually require multiple doses. This means the overall treatment cost could reach several lakhs of rupees (₹10-20 lakhs or more) depending on the specific course of treatment prescribed.
Other Considerations:
The cost can vary depending on the hospital and the number of doses needed.
Some hospitals may offer financial assistance programs or clinical trials that could reduce the cost for eligible patients.
Insurance:
In India, the availability of insurance coverage for treatments like APCEDEN® can vary. It’s essential for patients to check with their insurance provider to determine if this treatment is covered under their health policy.
For those seeking an advanced, immunotherapy-based approach similar to Provenge, APCEDEN® represents a significant option within India, albeit with high costs, as is typical with personalized treatments. It's recommended that patients speak with an oncologist who can provide more detailed advice based on individual medical needs and discuss the logistical aspects of treatment.
APCEDEN, a dendritic cell-based immunotherapy developed by APAC Biotech in India, is available at various cancer centers across the country. This personalized treatment is designed to boost the patient's immune system to fight cancer cells effectively. The process involves collecting tumor tissue and peripheral blood mononuclear cells (PBMCs) from the patient, which are then processed to create dendritic cells. These are subsequently administered as part of a customized treatment over several doses.
APCEDEN is available in major cancer centers, and APAC Biotech manages the logistics from sample collection to the delivery of the immunotherapy to the clinical site for administration. As this is a specialized treatment, it is typically available in advanced cancer centers partnered with APAC Biotech, such as those in large metropolitan cities like Delhi, Mumbai, and Bangalore.
For specific details on the treatment process and availability, you can contact APAC Biotech directly, as they are the primary providers of this immunotherapy in India.
TA rarely reads the comments so you will have to post your question or write him directly. Might be a good post. I believe Provenge is now approved in Europe.
Exactly. I also found a small trial from 2020 that indicated Provenge was better than either Zytiga or Xtandi at extending life.
That is very true, but still some people are on either of these drugs (abiraterone or enzalutamide) for very long time and claiming that it is because of enzalutamide etc.
I am on Bicalutamide now because it cost only 60 dollars per month and according to the ENZAMET clinical trial there was not much difference in the overall survival between people who received early docetaxel chemotherapy and had a polimetastatic bone disease with distant metastases in my spine and neck on Bicalutamide or enzalutamide.
OK, if enzalutamide would not cost 3500 A$ per month and if it would not have nasty side effects I would be probably on enzalutamide by now. But the medical system here in Australia would expect that the drug fail after 18 months and they would instruct me to join a phase I clinical trial for toxicity and they would stop prescribing enzalutamide. Even now by every visit to the oncologist they ask me if I want to join the astra zeneca phase I clinical trial for a new AstraZenecat to test for toxicity of the new AstraZenecat PARP inhibitor drug.
And it is not different in the USA. Someone wrote that he approached 5 centres of excellence in the USA and ask them how to proceed further and each of them recommended their own clinical trial like the way how to proceed with his Prostate cancer treatment.
I received the second opinion from a profesor of medicine that for my situation the phase I clinical trial first in human to test for toxicity is not appropriate now. Actually I am not even eligible because I don't have visible metastases on the scans, but to test toxicity you do not really need to have a metastases.
When I ask for a scan they say join the phase I clinical trials first in human to test for toxicity and you will receive lots of scans. I said to them that I talked to people on clinical trials and that they only getting ct scans and a nuclear medicine bone scan and that they don't even know what the PSMA PET scan is.
When I ask for a biopsy they say to me join the phase I clinical trials and you will receive lots of biopsy.
When I ask them could I get Nubeqa because I don't have any visible mets on any scans they say join the clinical trial and you will get Nubeqa.
My sister is a doctor in Serbia and says that everywhere is like that that they want you to get a medication paid by the pharmaceutical company conducting clinical trials ruther than the public health insurance like we have here in Australia.
I can understand that and that is why I am still on Bicalutamide.
I have to correct what I said above about enzalutamide not being superior than bicalutamide after consultation with ChatGPT.
The bottom line is that if you received upfront docetaxel chemotherapy you are driving your bone metastases into senescent and with the combined Degarelix it is probably not overly important are you on enzalutamide or bicalutamide if your bone mets are in a senescent state because they could stay there for a very long time. (that should be a take home message).
I was for six years only on Degarelix and I still don't have visible bone mets on any scan. I added six months ago bicalutamide because after SBRT radiation treatment of my Prostate after the initial decline of my psa to 0.25 the psa started to rise and I decided to add bicalutamide and my last PSA was 2.5.
Q. According to the ENZAMET clinical trial what was the difference in a survival rate for polimetastatic Prostate cancer Patients with distant metastases who received early (upfront) docetaxel chemotherapy plus either enzalutamide or bicalutamide?
A. In the ENZAMET clinical trial, the survival outcomes for patients with de novo polymetastatic prostate cancer (with distant metastases) who received early (upfront) docetaxel chemotherapy along with either enzalutamide or a first-generation non-steroidal anti-androgen (like bicalutamide) showed important differences:
Patients who received upfront docetaxel plus enzalutamide had improved overall survival compared to those who received docetaxel plus a first-generation anti-androgen.
Overall survival benefit: The addition of enzalutamide to docetaxel significantly improved survival rates compared to the combination of docetaxel with bicalutamide. Specifically, in the high-volume (polymetastatic) disease group, those who received enzalutamide experienced a longer duration before disease progression and an increased survival advantage.
However, the trial also showed that the benefit of enzalutamide was less pronounced when docetaxel was used upfront, as both treatments had a strong effect in managing disease progression.
In summary, while enzalutamide plus docetaxel offered a survival advantage over bicalutamide plus docetaxel, the addition of enzalutamide provided more benefit in patients not receiving concurrent chemotherapy.
Well. What can I say. Good for you. You have been interested in this for sometime.
Good luck wishes to you, sounds like you have Thought this out
Did your insurance pay for it? What previous treatments did you have to do before the doctor would prescribe?
Yes, Medicare plus my supplement are supposed to completely cover it.
I have only had Lupron, since 11/2018. No chemo, radiation, Zytiga or Xtandi.
Once my PSA began rising and with me being metastatic, I qualified as Castrate Resistant Metastatic PCa. That's the point where a patient qualifies for Provenge (and coverage of the treatment).
Having said that, the bills haven't started arriving yet. Should know for sure soon.
I didn’t have any SEs until the last infusion, felt like I do after a flu shot, lasted a day or two.
I remember when my Urologist 6 years back suggested I do Provenge and said I wanted to do some research. He was fine with that. After reading Provenge studies, they took a large group of individuals with all stages of prostate cancer and found out they average an increase of 4 months of life on average. Personally I thought to myself am I that desperate to extend my life 4 months if I fell in the average range. Sorry but I chuckled on that thought. I confronted my oncologist about Provenge and he chuckled also. So needless to say I never did the Provenge. If it was 2-4 years I’d do it in a heartbeat. To each their own path. Right now I’m doing so good I can only say it’s a miracle at this point. Best wishes and prayers to all. God has a plan for each and everyone one of us.
I understand how you feel. Nothing extends life far in those trials, but many men in them are in terrible physical shape, bringing down the median numbers. And the earlier you do a treatment, the better, is supposedly the way with Provenge. But at least you've done well so far, so perhaps Provenge wasn't necessary.
Great I'm happy to hear, I'm waiting for mine in a couple of weeks. Does your veins good enough? I have to install a central catheter next week.
I don't like it but my veins are very thin.
Please continue to update.
My veins are fine but we put the CVC in anyway. By doing that, we cut the time from 4 weeks to 2 weeks.
I'll continue to update. Good luck with your treatment.
I had my first treatment successfully without the cath. Second failed and they ordered me for surgery to get it. I came out with a port not the needed cath!
Just had my third treatment done by my poor veins.
Wow I'm sorry to hear.I have completed mine on last Thursday.
I had a catheter that worked poorly on my first collection, great on second and terrible on third that required using one arm for collection and the cath for retrieving the blood back.
After second infusion I had so bad side effects that I ended 3 days in bed.
And during last infusion I have got so bad chilles that they had to stop treatment until I relaxed using 6 medications shoots, then they continued slowly until the end.
Not an easy walk on the park but I'm glad it ended.
Hope that all this misery and pain will worth the journey.
Thanks for your reply.
Provenge 
Provenge Reaction 
Provenge
What first?: Provenge or Nubeqa?
