Are these really great breakthroughs

I keep reading about Provenge and the more recent drug approvals. Everybody is just thrilled and they are considered major breakthroughs.

Now, I can understand Provenge being considered a breakthrough in the sense that maybe this is a new and better way to treat cancers so that down the road real cures/remissions using these ideas will be found.

But, when I read some of the articles, we find that new tx. did better than old tx. yyy. But the median is 14.5 months compared to 10 months. Okay, I realize that's a median. Half of the people do better for longer. But, that's incomplete information. HOW MUCH LONGER? Are we talking the REASONABLE possibility of an additional year? Then I read about the horrendous SE of many of these drugs. Even provenge has a whole new group of SE in the auto-immune arena.

I really do want to get excited and jump up and down, because there is a high probability that these drugs are in my future (heck, for anyone who fails SRT, we KNOW these drugs are probably in your future). I'm personally hoping I can stave off this beast long enough for some real good drug developments. But, why am I not as excited as it appears I should be.

Mel

I think the Provenge is in the category of its better than nothing new. For what it costs, and the side effects, I cant personally see it as a major breakthrough drug. Hopefully, neither of us will need to find out.

David in SC

TimG -- we all want a cure for cancer but for now i'll take what i can get.

ed

Hi Mel,

I have had the same thoughts. However, the shape of the distribution curve is what is lacking in most reports. Left skewed bad news. Right skewed could be good news and normal distribution you would need to know the standard deviation. I.E. what is the spread.

My personal opinion is that Provenge was given a thumbs down several years ago. Administrations change the company does a little more research and re packages the results and Voila! there is approval. Otherwise how would the company get back the $1B investment. Estimates I have seen on line indicate they will make this back the first year. It will take two years for the medical community to realize they have been had on this one.

Seems that the Aberiterone (sp?) has similar characteristics.

On my darker days I realize that there is more money to made in treating than in curing this disease and sink into a feeling that no one is looking for a cure. Only a device to prolong the cash flow.

Don

Ohio State,

Good to hear from you. Hope all is well.

I know this is an area that you have expertise and personal experience with.

Goodlife

compiler said... You are much more optimistic than I... Mel, From the little that I know about you, and what I know about me, you will take a more pessimistic perspective and I will take a more optimistic perspective…hey, that’s what makes the world go around.   That being said, you should read the opening of THIS PCRI article by Dr Charles “Snuffy” Myers on optimists & pessimists...really, you should read it.   You’ve expressed here many times that you are comfortable and set in your ways regarding lifestyle modification, or non-modification as the case may be (nutrition, exercise, stress reduction to help reduce PC progression), but these are the factors that appear to help stack the odds in one’s favor for a better-than-average outcome. So if you want to talk about just the average outcome, you can get a prediction of the probability of progression after 5 & 10 years after your SRT as a starting point from a nomogram…I’m sure you’ve already done that.   Keeping in mind that many men do not progress, extrapolate to find the year where the probability crosses 50%.   After that there is the HT-induced remission; Dr Mohler uses 5-years as typical (not 1-5 years; except for particularly aggressive cancers, that’s a myth).   The Myers article I linked above says this in addressing the myth about the short-term benefit of HT: “I conclude that hormonal therapy is far more durable than generally thought. In fact, almost all men who recur after radical prostatectomy or radiation therapy will continue to respond to hormonal therapy after five years and about half will continue to respond after ten years.”   Nobody can predict with certainty any particular outcome for anybody with any cancers--certainly you understand the statistical concept of variation--but the key is to do everything in your power to push yourself to the right-hand side of the skewed survival curve.   What variables can you affect?  If you want a conventional outcome, then just stick to conventional treatment.   In my humble opinion, anyone who uses only alternative medicine techniques (and completely foregoes traditional medical approaches such as surgery, radiation, HT, etc) to combat prostate cancer is foolish.  At the same time, anyone who uses only traditional aggressive medical techniques (previously listed) without supplementing with integrative medicine techniques such as lifestyle changes (diet, exercise, stress reduction, etc) is similarly imprudent.

I love you, Mel,
Hang in there. I had everything bothering me at one point of this stupid journey and I really hated that feeling. Just to let you know I'm cheering for you every inch of the way.

Tony

Mel,
These are terrific breakthroughs. Along with other short term life extending drugs we are seeing some guys lives extended many years. I for one am watching this stuff closely as I view it impossible that I don't deal with this again. There is my pessimistic moment. But if I have to I like seeing what we have seen in the last year : Provenge, Cabazetaxel, Abiraterone...etc.

Very nice. I know we need more but these are good ones.

Tony

what are the side effects of Provenge? thanks

Edwin J. Peters
[email protected]
http://www.prostatebiopsyprocedure.com/prostate-biopsy-procedure

Newporter said...
I am more optimistic about Provenge. The phase III double blind trial were for treating terminal cancer cases - patients who had no more treatment options and were too late for anything else. In that situation, 14.5 months survival vs 10 months survival is very significant. I suspect when the treatment is used for moderate or early PC, the result could be dramatic.

This is the kind of thing that I wonder about.  I believe in the "throw everything including the kitchen sink" method at the beast as early as possible to knock it's feet out from under it as much as possible.  Are trials being done with Provenge at an earlier stage for patients who have not yet failed HT?

Interesting comments. Overall, I think I feel more optimistic than pessimistic after reading this thread. At least at my age (66), for which 15 years is a really long time. I would feel different if I were younger, and pray for a real breakthrough for the younger guys.

These "Breakthroughs" are are mostly in the stock price of the labs that develop them. If they can't get a patent on it, they are not interested in it..Pomegranate Juice seems to work as well as many of these "breakthrough" drugs and treatments with zero side-effects..What good is a little extra time if you are bed-ridden with advanced cancer symptoms and drug side-effects?? Quality of life becomes very important at this point..

The side-show that goes on back-stage to get these drugs patented, tested, passed clinical trials, FDA approved, and then marketing agreements negotiated, price-points set, takes ten years while countless cancer victims continue to die. If the FDA only approves the drug for late-stage cancer, then no insurance company will pay for it's use on early-stage patients..If you have enough money, $5000/month, sure, go for it...We have spent many $Billions$ of dollars of taxpayer money on cancer research. But when a useful, patentable drug is found, it's always held by a private for profit company..

Remember the Salk Polio Vaccine?? Now THERE was a major breakthrough in medicine. Within 6 months of discovery, it was being distributed FREE in public school across the country..Times have changed..

Fairwind -- so are you for or against pomegranate...you seem to go back and forth on that one?

ed