An Excellent talk on Provenge and earlier immunotherapy

http://www.patientpower.info/video/active-immunotherapy-could-it-benefit-men-at-an-earlier-stage-of-prostate-cancer/?autoplay=1&utm_source=health-topic-alert&utm_medium=email&utm_campaign=apc-2012&utm_content=heading

Worth looking at

Mel

Good description. I should probably have included that.

Interesting that he still talks of using immunotherapy after reaching the castrate resistant state. But implicit in the discussion (yet unspoken) is the thought of maybe using it earlier.

We may have a new paradigm in 10 years, where maybe HT is given much later in the course of the disease (just a suspicion)

Mel

Absolutely. There is no doubt that opinions from true experts are invaluable with all the new stuff

Mel

This web video about Provenge is not new information. It is an examination of the original data now separated into different quartiles. It does not mean that those with lower psa have greater benefit from Provenge. It means that those with lower psa survive longer, which is not considered news in my world. The effect of Provenge, if any, was consistent across the groups though the numbers were too small to reach significance and the original study itself was not designed for this sub-analysis. The consistency does provide some evidence of a treatment effect.
I would say that those who initiate a treatment, any treatment, at a lower level of psa, with other factors generally equal, would survive longer. They would also have more time to access other treatments and benefit therefrom.
l would like to see more discussion of CD54, the measure of immune system response, and survival. We are all quite aware that psa is an unreliable measure for this treatment.

Post Edited (tarhoosier) : 5/31/2012 9:40:23 AM (GMT-6)

Met Paul in Miami at a prostate cancer event a few years ago. Great guy and he is also a prostate cancer survivor. I respect him a lot. I agree that this is not new news. Currently my doctor, one of the investigators for Provenge, also says the same. He was adamant in recommending it to Todd here even when Todd was being told it would not help him.

I think otherwise...

Tony

I was one of 40 that were selected in 2011 to participate in a study of men that were recently diagnosed and were going to have a radical prostatectomy. My PSA was less that 22.1.

I am know out of surgery 12 months now, had cancer in the margins, in the seminal vessicles, perineural nerves, lymph lode, and was graced with Gleason 9 from the pathology. Fortunately, I am and have been since surgery non-detectable. I had three Provenge treatments before surgery and one post surgery for a total of four treatments.

I am very religious and believe at times, fasting and prayers can be powerful and want to give credit to God if that is the case. But I just watched my neighbor die of this disease over the last five years and he was a good man and God should have blessed him as well. So after the benefit that came from the heavens, I have to give credit to a very skilled surgeon and then give credit to Provenge. Statistically, I should not be non-detectable with an ultra-sesnsitive test, Don't get me wrong, I am thrilled to be non-detectable at this point.

We talked for months with the leading Uro and the U.O. about my very low testosterone levels and they recommended to initiate replacement therapy with a daily gel. The only problem with that is that my bi-monthly testing now became monthly PSA testing, to make sure we didn't throw a match on my cancer encouraging it to gain new legs and take off. I have seen many benefits with the replacement with more energy, sense of wellness, sex drive, etc.

I am very interested to read the report on the 40 if us that participated in the study that closed in march or april of 2011. Nor sure when the report will be published, but look with anticipation that using the T cells early helped find and destroy the cancer and that it can bring a sense of hope a possible use for many more HW brothers for its application.

Bravo to the researchers for their out of the box thinking that may find a significant tool for us with this new Immunology treatment.

Sequoiaranger, I am so saddened to hear that you had no benefit. God bless you my friend.,

This analysis was not powered to provide a meaningful result due to the small number in each group. This means that the result could result from chance. This study makes that clear in their abstract. I believe it is also likely that the result was from the opportunity of men in the lowest psa group to benefit from other treatments following the Provenge treatment. Dan Petrylak has shown in another small analysis that Provenge treated patients appeared to respond better to Taxotere following Provenge infusions than men without Provenge previous to Tax.
I think Provenge may show a treatment effect though this current analysis could also show how men respond to Provenge +/- X. I wish the study had taken a fuller view of the course of treatment for these men.