Immunotherapy Treatment

[Conlig1940]

Is Immunotherapy only used for Advanced Prostate Cancer OR Is it being used for say Gleason 4+3= 7 cancer . And is it used alone or in combination with hormone and chemo. etc ?

[Tall_Allen]

Provenge is only used for metastatic and castration-resistant prostate cancer.

[GoBucks in reply to Tall_Allen]

It seems like many treatments are started earlier. I'm surprised no one tested upfront/ early provenge. Or have they?

[Tall_Allen in reply to GoBucks]

I agree. In fact there is a clinical trial that should have results soon about using it inmen on active surveillance:

clinicaltrials.gov/study/NC...

This trial found that there was a lasting immune response even in men who were biochemically recurrent after failed local therapy and before metastases were detected:

ascopubs.org/doi/10.1200/jc...

And this trial among men who were mHSPC, found it increased doubling time, but the increase in time to biochemical failue (from 15.4 to 18.0 months) was not statistically significant at the relatively small sample size (n=176).

aacrjournals.org/clincancer...

Even among patients with mCRPC, it works better if used earlier:

goldjournal.net/article/S00...

I think it works best when used in combination with therapies (like radiation, radiopharmaceuticals, and chemotherapy) that increase antigen presentation.

[addicted2cycling in reply to GoBucks]

Early 2015 had GL10 (5+5) tumor in Right Half of prostate cryoablated.

Months later had a Keytruda+Opdivo+Yervoy combo injected in former GL10 location for System Immune Boost.

So Far - So Good.

[Boonster in reply to addicted2cycling]

I was also GL10, and was treated with Opdivo and Yervoy much as Cycling was treated, but minus the Keytruda. That was in 2016.

I received further treatment with radiation in 2021 and then 3 years of Orgovyx. Now on active surveillance.

[Sagewiz]

I have the same Gleason numbers. They say molecular metastasis is almost certain, but until my numbers change, no other therapy options are appropriate. The good news is there are other options if that happens. The consensus is that it is not a matter of "if" but when. Fortunately with my diet and suppleent program they were able to take me down to 500mg of abiraterone from 1000 and my numbers are staying steady. QOL has been an issue just from the exhaustion.

[Mgtd in reply to Sagewiz]

Hi Sage

I had to read your response twice because something just did not ring true with me. Perhaps you can qualify for me the idea that with 4+3 it is just a matter of when not if the cancer will spread. Are you saying remission is not possible with 4+3?

I do not disagree that a certain number of guys with 4+3 will go onto to have cancer spread. However there appear to be many that go into remission after their initial treatment.

I have not seen the percentage of each group but perhaps you have run across those numbers and have taken the “half empty approach” in your thinking based on your research.

I happen to have the same numbers but have taken the “half full approach” and until proven wrong by a rising PSA, etc life goes on for me. At this point nothing I can do will change the outcome.

[Sagewiz in reply to Mgtd]

Because of my genetic variants, they have given me a terminal diagnosis. So it is not JUST the 4+3. My original prognosis was 1-year if I had no treatment and a 52% chance of making it to 5 years if I did all treatments available. If my number change, doing HIFU and chemo are still options, and there may be an immuno option on the other side of that as well. I don't fully buy into it, but I realize it is a possibility. I am throwing all of my complementary alternative care at it as well. But that is not the case for all 4+3s,, obviously.

[Mgtd in reply to Sagewiz]

Sorry to hear that. When I read your bio I did not see that or perhaps did not understand the impact.

[Mgtd]

After I posted the above I looked up the actual percentage and found that according to John Hopkins only 20 to 30 percent have reoccurring cancer.

[Miccoman]

Since you asked, in 2014 an excellent research oncologist from Moffitt Cancer Center in Tampa advised me to stay on ADT, in all its variations, until my PSA reached 2.0. Then stop and do immunotherapy. I followed his advice and I do believe he was right in saying men who do immunotherapy when ADT stops working have a better QOL. I certainly have surprised my current doctors.

Oh, and always remember you are unique: YMMV

[NanoMRI]

My 4+3 made it to para-aortic lymph nodes; I find no solace in my lesser Gleason. Also, I am not aware of one best treatment strategy - as treatment is continually evolving and individual tolerances and co-morbidities are imporant considerations.

[j-o-h-n]

Immunotherapy (Keytruda) worked for my Lung metastasis due to Melanoma on my neck (Note: Not Pca related).

Good Luck, Good Health and Good Humor.

j-o-h-n