Thoughts on Provenge?

[tucker_man]

During my follow-up visit on Friday, I was offered an opportunity to participate in a research study on using Provenge to treat low-risk early stage PCa. I haven't researched Provenge yet, though I know it's immunotherapy. [I'm T1c, Gleason 6, 60% in one biopsy core, PSA 6]. I would be on active surveillance while Provenge is administered (assuming I don't get a placebo). While I have a lot of questions (two being, how do they measure effectiveness (I don't want regular biopsies if that's how they measure)? and will they control my own efforts at natural remedies?), I wanted to run it by you guys. If you had access to Provenge, would you jump at the chance or is this something I should avoid like the plague? Seems like immunotherapy is the future of cancer treatment.

[Tall_Allen]

I don't know if immunotherapy is the future of prostate cancer treatments - so far it has been disappointing - except for Provenge. They will measure success by how long you are able to stay on active surveillance without progression/treatment. It certainly involves 2 follow-up biopsies (every active surveillance protocol in North America requires follow-up biopsies).

clinicaltrials.gov/ct2/show...

[AlanMeyer Moderator]

It's my understanding that the original trials of Provenge, like almost all treatment trials, were with men who had already failed the standard treatments. The theory is, or at least was, that you don't use an experimental treatment if a standard treatment that is known to work (e.g., ADT) has not been tried yet or is still working. However, we are now learning that treating cancer early gets better results than treating it late and that relatively low power treatments (and I think Provenge is one of them) may perform much better when dealing with a less aggressive cancer than when dealing with an aggressive cancer that has already mutated to defeat the conventional drugs.

So, yes, I think Provenge might be worth jumping at.

Ask the trial people what biopsies you might have to get and when, and what supplements might be permitted or prohibited.

Personally, I wouldn't refuse the treatment just to avoid an extra biopsy. Biopsies are a pain in the butt, but they don't last long and I think the pain is bearable - at least mine was. They have a plus for you too because you'll get some additional information about your cancer from them.

Best of luck.

Alan

[packfan]

I was in a similar trail 2 1/2 years ago, and think the idea of using immunotherapies when there is low tumor burden is a great idea. My only surprise was that everything except for the immunotherapy agent was billed to my insurance as normal care (substantial and frequent blood work, infusion costs, etc). My insurance agreed to cover "normal care", but strongly disagreed with the medical university on what normal care was. I don't think this happens often, but I did get stuck with a hefty bill.

[tucker_man in reply to packfan]

Wow, good to know, I'll definitely be asking about costs.