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Dendreon: The Challenge Of Misinformation

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Posted 8/30/2011 2:58 AM (GMT 0)
interesting read.

http://seekingalpha.com/article/290286-dendreon-the-challenge-of-misinformation

ed

 

Posted 8/30/2011 5:16 AM (GMT 0)
F8,

Thank you for the article. I was a recent study participant this year with Provenge. I believe the current study has been closed. The previous study was for men with advanced prostate cancer that the study concluded extended their lives by four months. The study group that I was in was for men that were recently diagnosed with PCa and were going to have a radical prostatectomy. This study gave the drug for the three rounds to all participants and they studied the biopsies pre-surgery to the tissues samples taken from surgery. After surgery they also randomized selection for a fourth treatment, which I was selected and received.

The hope was for my study group that Dendreon could identify another group that could benefit from the vaccine more so that those with advanced cancer (not to say that men with advanced cancer that had their lives extended four months to three years didn't benefit because they did). I have a best friend that is a pharmacist and he researched Dendreon's research and was very positive about it and had no reservations in having me participate in it. Apparently, researchers are having great success with those suffering from Rhumatoid Arthritis by attaching a protein to white blood cells (similar to what Dendreon is doing).

I have horrible pathology and only hope that Dendreon is on to something and somehow it had had a positive impact on my high grade PCa. I am reaching out to see if anyone else on this website has had experience with Provenge to see if they have a longer history with it and if it provided any positive benefits in reducing their cancer, extending their life, and so forth.

Thank you for sharing the article.
Posted 8/30/2011 7:12 AM (GMT 0)
Ed,

That certainly puts the subject in a different more positive light. All I had read was the high cost and low months of life extension. Interesting read for sure.

david
Posted 8/30/2011 2:09 PM (GMT 0)
Good article. One of the first that I have seen that addresses the shape of the curve (indirectly) that yields the median of 4 months. Sounds like the tail extends quite a ways. If you are fortunate enough to be in the upper regions the expense may be justified. I suppose there are traits that make one more likely to benefit but I have not seen these published.

Don
Posted 8/30/2011 3:39 PM (GMT 0)
One Correction to the Article from my Recent Past Experience:

The article does mentioned " A full course of treatment entails three infusion over a one month period. And then the patient can sit back and enjoy the treatment's expected extension of life".

I want to correct the author because it is three treatments, but it is administered once every three weeks, and then you have to wait two weeks after the third infusion to have your surgery. One the week of the treatment, you go to a Red Cross Blood Center for a Leukaphresis (where they extract your blood, run it through a machine so all your blood flows through twice and they spin out your white blood cells), they ship it to one of their two processing centers (they shipped mine to Seattle) and then return in three days later where they infuse your white blood cells with the added proteins. The Leukapheris usually takes about 3 hours and the infusion takes about two hours.

The three treatments are over a nine week period of time (not a month represented by the author) and then the study requires you to wait another two weeks before your operation, so it requires 11 weeks before you have have your surgery.

Apparently there is a window of three months from diagnosis for corrective action before the Partin table percentages begin to loose their accuracy. So one has to take into consideration, is it worth waiting to have surgery (which was a requirement for the study I was on) eleven weeks? My wife and I struggled with that but since my Urologists was so positive on the "Vaccine" approach versus the chemo approach, we decided to participate, and only hoping that it will and has made a difference with my nasty PCa.
Posted 8/30/2011 7:05 PM (GMT 0)
Median survival is a standard measure for experimental cancer treatments for patients with few approved treatment options. It is the accepted way to determine success and to compare treatments with each other. To rewrite the trial results after the fact and to play up the benefits without adding the results for the weakest of the men is akin to shooting an arrow and drawing the target around wherever the arrow lands.
It is true, as the author of the article says, that the Provenge survival curve widened only at 6-8 months out from treatment This means (to me) that those who were the sickest, those with the most aggressive and most difficult cases found little to no benefit. It is not possible to know who those men are at time of treatment. Those who lived longer had the additional benefit of the greater survival curve differential. This may be true for other cancer treatments as well. It is not unique to Provenge.
The author of the article owns Dendreon stock and writes approvingly. Caveat emptor.
Posted 9/14/2011 5:09 PM (GMT 0)
I have started my Provenge-ing (first infusion three weeks ago). I was able to get a "grant" to defray much of my costs, but the main question I have, that seems unanswerable is:

HOW DO WE KNOW IF THE PROVENGE IS WORKING? I do not have bone metastasis, but I do have a residual lesion in the prostate that intruded recently into the neck of my bladder (closing off my urethra, and surgically inspected and snipped). I am told that Provenge does not alter the PSA (seems hard to believe, because PSA production seems DIRECTLY related to cancer activity), my former sole determinant of cancerous action. The only way they actually found the residual lesion was the unreliable "Prostascint" scan that is known to register "false negatives". I can't rely on the Prostascint scan to tell me if the lesion has been reduced.

So....How do we MEASURE the working progress of Provenge?
Posted 9/14/2011 5:57 PM (GMT 0)
Hello Ranger. That is probably a question best posed to your oncologist -- it is sort of a technical question that many laypeople (like me) could only guess at. And it seems too important a question to rely on us laypeople. Having said that, you might ask your oncologist whether a measurement of CEA (Carcinoembryonic Antigen) or PAP (Prostatic Acid Phosphatase) or CGA (Chromogranin A) -- or some other tumor markers -- might indicate whether your provenge is "working." Of course, you might need baseline levels of these markers in order for this to be useful. Best wishes, Medved

Post Edited (medved) : 9/14/2011 1:54:40 PM (GMT-6)

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