HealingWell
Search Close Search
☰

Provenge in early stages while hormone sensitive

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 10/10/2016 10:24 PM (GMT 0)
I have have surgery in 2011 and radiation in 2015 and my PSA is doubling monthly - now 3.8.

I expect to start hormone shots next week but am considering out of pocket payment for Provenge and am seeking information that would help me with that decision. Please advise.
Posted 10/10/2016 10:39 PM (GMT 0)
The fact is, ADT has been proven far more effective at far less cost than Provenge..If you have the money and are willing to spend it on Provenge, go for it. You are probably not the first one. I would contact the company that performs the treatment and get their take on it...They know more about how effective it is than anyone...
Posted 10/10/2016 11:33 PM (GMT 0)
I am thinking of doing the ADT in conjunction with the Provenge in hopes that the Provenge will have a positive effect on extending survival. Seems theoretically possible even though the trials were done on hormone resistant cases.
Posted 10/10/2016 11:36 PM (GMT 0)
Evidence for early use of Provenge is mixed so far. The PROTECT trial reported no significant difference in time to biochemical failure in men who used Provenge while still hormone sensitive, but it did prolong the PSADT. But with only 5 years of f/u, it was too soon to detect a survival difference.

Randomized Trial of Autologous Cellular Immunotherapy with Sipuleucel-T in Androgen-Dependent Prostate Cancer

Another clinical trial (called STAND) found that there was an immune response in men with biochemically recurrent PC. At only 2 years of f/u, it's too soon to detect any clinical benefit.

Antigen-specific immune responses through 24 months in the STAND trial: A randomized phase 2 study evaluating optimal sequencing of sipuleucel-T (sip-T) and androgen deprivation therapy (ADT) in biochemically-recurrent prostate cancer (BRPC).

Cost is $93,000 for 3 infusions.
Posted 10/10/2016 11:52 PM (GMT 0)
Thanks. Without proven results, it is hard to make a decision about going with early treatment. However, I can not wait the years to pass to get more conclusive evidence from clinical trials. Hence the dilemma.
Posted 10/11/2016 12:20 AM (GMT 0)
Is $93,000 the total cost?
Posted 10/11/2016 2:32 AM (GMT 0)
In my opinion, the cost of many of these drugs and treatments is negotiated backstage on a case by case basis..Insurance companies and hospitals negotiate the cost of medical treatment. The "list price" posted by the patent holders is merely a place where negotiations begin....But your quote of $93K sounds about right and is considered reasonable in the cancer treatment business...
Posted 10/11/2016 7:55 AM (GMT 0)
I think you get more out of immunotherapy when it is combined with radiation or chemo. But you would have to wait for detectable mets for either of those.
Posted 10/11/2016 2:51 PM (GMT 0)
Regarding the cost, I was just searching and every reference to the $93,000 that I found is from the information in 2010 after the FDA and Medicare approved it's use and reimbursement. I didn't find more recent cost information in my limited and brief search. The Provenge website does not state the cost(that I could find) but did list several financial assistance programs. I suggest you contact them directly to find out the specifics for your case. Website is www.provenge.com.

As has been stated the actual reimbursement will depend on the third party arrangements (insurance, Medicare, etc.). For a self pay (non-insured) I assume you would have to negotiate that directly with Provenge and the clinic that does the work.
Posted 10/11/2016 3:27 PM (GMT 0)
Why not wait for the results of Prostvac which is due out shortly I believe. Not sure how much that would or if it would even be an option...just throwing it out there.
Posted 10/11/2016 7:04 PM (GMT 0)
JNF-

Neither Medicare nor private insurance will pay for off-label use.
Posted 10/11/2016 7:55 PM (GMT 0)
TA. I didn't infer that it would for Provenge. However there are times off label reimbursement does get covered. Avastin for eye injections is an example.

My point was that I couldn't find current pricing data and in any event reimbursements could differ from one coverage to another. And for Tom, he will have to go to Provenge and a provider to see whether he can even get an off label use even with him paying the cost.
Posted 10/12/2016 4:10 PM (GMT 0)
My insurance co paid about $54,000 for the Provenge treatments, so there should be room to negotiate. For what its worth I had the treatment's early after recurrence while I was on Lupron & Casodex. Its been about 18 months since the treatment and 10 months since ending the ADT and have been undetectable for 6 months.
Posted 10/12/2016 6:47 PM (GMT 0)
Glad to hear that you did get some insurance coverage and that your results on Provenge have been good. I am not optimistic about coverage as I am on Medicare.
Posted 1/30/2017 11:42 PM (GMT 0)
To Ferb40,
I see you had Provenge how are you doing? My dad is starting it and Im trying to see how others are doing and if there is any success with you? I know there is no medical test to see if its working so how do you know that its worked for you? Please help Thank you, Olivia
Posted 1/30/2017 11:47 PM (GMT 0)
While pursuing the option of Provenge, my cancer went crazy with the PSA doubling every four weeks. Consequently I went directly to chemo combined with hormone shots. Will be pursuing Provenge as an option after chemo is done.
Posted 1/31/2017 12:03 AM (GMT 0)
You "know" it worked because you live longer. You can only infer that you'll live longer based on its known effect across the population. BTW - reduced PSA is not always an indicator that one will live longer. In fact, sometimes PSA does not go up when mets have been expanding. One can only go with what's been learned from clinical trials, and hope that it applies to you as well.
✚ New Topic ✚ Reply