Anyone currently using or previous used LEUKINE for Advanced Prostate Cancer?

I've been reading with curiosity about Leukine. Any one have experience with this for Metastatic Prostate cancer? Last info I saw on this sight was from 2012.

Hi Jerry
, Leukine came up in my research for a next step for my husband. We are waiting on whether he qualifies for a Anti-PDL-1 clinical trial. Also, tests for mutation to see if some other "Target Therapy" may be a possibility. As his PSA is continuing to rise on, Lupron, Zytiga and Xtandi all at the same time. Last year he had 6 rounds of Taxotere/Carboplatin combo. Most of the rumors responded and PSA cam down to lowest of .5. Continued on Degarelix. And then 2mo.later started its gradual climb. I saw some articles showing good results. Some in combo with Taxotere. Some as a "single Agent" as your self. Some of the articles showed great results. But, I don't hear to much about it. And these articles were from 2011-12. Looking for stories of success, side effects., Insurance approval.at what point is it to start for Optimal results. Of course some say early with slow minimal,advancement. Want to get as much information armed and ready to present to his Med. Onc. On our next visit. Thank you so much for responding and hope and pray you are having great results with it.
Barb

Barb1-

Be careful about using it if you want to be eligible for the anti-PD-L1 clinical trial. Many clinical trials of immunotherapies eliminate those who have tried other immune agents. Of the two, I would definitely go with the anti-PD-L1.

Leukine is a brand name for a kind of GM-CSF, which is also part of Provenge therapy.

If you decide to use it, and your insurance will pay for it, consider using in conjunction with spot radiation of any mets that may be detected at some point.

- Allen

Last summer Tall Allen had advised me of someone he knew using Leukine but cautioned it was very expensive.

Since it is also a component of Provenge, I sought 2 PSA increases at least 14 days apart to qualify for Provenge, then after qualifying resumed taking the Zytiga.

I did the Provenge every other weekend til I had 3 treatments that ended 11-3-14 in conjunction with SBRT 5 fractions of very high dose radiaiton every other day that ended 10-20-14 such that they overlapped to leverage any potential abscopal effect.

It is tough to quantify any benefits of Provenge monotherapy as PSA does not necessarily decrease and sometimes increases. So I measured the combined effect and not by component.

Hard to say whether it is the Lupropn, the Zytiga, the SBRT or the Provenge that brought my PSA <0.01 for past 6 or so months.

www.medicalnewstoday.com/articles/242784.php

After 9 months of Zytiga which would be Memorial Day 2015 I start intermittent hormonal therapy, I had my final one month Lupron shot last week.

Not every one is sold on Provenge but even if it is only peace of mind that I threw everything I could at it, that was my goal. There are success stories like Todd who went from PSA 3200 to undetecitble using Provenge (early adopter so he had to fight insurance companies using state insurance commissioner), plus Zytiga, Lupron et al.

toddseals63.blogspot.com/

you can do Forum searches on "provenge" to get more info.

For that matter, you can also search for past thread on Leukine but use the qualifier Prostate as it also has uses on other cancers

www.healingwell.com/community/search.aspx?cx=010904608862850737972%3A1v124njdg5g&cof=FORID%3A9&ie=UTF-8&q=leukine&sa=Search&siteurl=http%3A%2F%2Fwww.healingwell.com%2Fcommunity%2Fdefault.aspx%3Ff%3D35

Jerry L. said...
Jim,

To qualify for Provenge, did you have to get testosterone checked at the same time? I think I can manage 2 straight rising PSAs, but how would I strategically get testosterone to castrate levels at the same time? Can't wait til you get to enjoy a break from the meds....good for you...

I've been very fortunate with the price tag of Leukine.

JL

Hi Jerry - I went back to an old post to get your metrics

Jerry
11/09 Dx at Age 44 ----- 4.03
12/09 DaVinci Surgery,t3b,g9 <.05
2/10 Adj. Radiation ----------- <.05
3/11 PSA Rise/Scans/Spot ---- .09
on Pelvic Bone
4/11 HT/XGEVA/Spot Radiation -- .06

2012 -- <.015 (ADT3 until October)
2013 -- <.015 (off HT entire year)
2014 -- <.015 (off HT entire year)
Jan. 2015 -- <.015
Feb. 2015 -- .023 2/10 .021 2/13
Mar. 2015 -- .018
--------------------------------------------------------
I do not know the answer to your question. I know Dr. Turner had access to both my PSA increases and the associated T levels, but not sure what he had to file with Dendreon the Provenge manufacturer.

Even before Lupron, at diagnosis my T was only 293 and after first month of Lupron w/o Casodex I had no flare which kind of confirms I was misdiagnosed with bone mets, my PSA dropped from 3.68 to 0.90 and T = 24. My understanding is drop may be even quicker with Firmagon instead of Lupron

Also mine was all as an initial treatment beyond HT (no prior surgery nor radiaiton) T was already at castrate levels quickly.

The Provenge site does not mention T levels at the micro level, not sure about the fine print

www.provenge.com/treatment-and-me.aspx

"You may be able to receive PROVENGE therapy if:
You are on hormone therapy and have rising PSA levels
Your cancer has spread from the prostate to other places, such as your bones
You are not taking narcotics for cancer-related pain"

www.provenge.com/provider-locator.aspx

From your question I assume you are still off HT (see criteria 1 above) and T has gotten back closer to normal levels, or at least well above 50 even though PSA remains undetecible in various flavors. Again with Myers, I assume your DHT and serum D and calcium and cardio metrics are being monitored.

So gotta decide if Provenge is worth it if indeed T must get back down to qualify.

Another of my understandings is that Dr Myers is not a proponent of Immunotherapy so you might have to arrange a consult with Dr. Mark Scholz or Dr Richard Lam or Dr. Jeffrey Turner in Marina del Rey CA as they have good success getting guys approved for Xtandi or Zytiga quickly .

"If you are interested in PROVENGE, it is important to talk to your doctor to find out if the time is right to start your treatment.

Some doctors may not have the facilities needed to administer PROVENGE. If your doctor isn’t equipped to provide PROVENGE, don’t worry, just ask to be referred to a doctor who is able to provide the treatment.

While talking to your doctor, It is important to remember that PROVENGE may not affect your PSA levels. In the PROVENGE clinical trials, the main goal was not to lower PSA levels—it was to extend life. So even if your PSA levels do not go down, PROVENGE may help you live longer.

To locate a doctor that can administer PROVENGE, simply enter your ZIP code in our Doctor Locator...."

But you gaming the metrics would open up another bucket of worms on the chronology trackings you and Myers are doing..

I know the theory says Immunotherapy makes all future treatments more effective but I would not have done Provenge as a monotherapy, just in conjuntion with SBRT.

I probably could have gone another year, possibly many more on Lupron monotherapy but felt eventually it fails and then the endless cycle of one monotherapy after another. The good news is that by then R&D may have come up with a simple treatment toward cure.

So I wanted to give the G9 the attention it deserves and hit it hard where it hurts while I only had the 3 micro LN's in pelvic region, suspicous on F18 that if I recall you do every 6 months and then confirmed on C-11 Acetate.

Even though PSA is a crappy indicator for my G9, it's what we will monitor while I am on IHT, (no scans til we have reason to suspect mets) but once PSA >=1, (rather than some higher bogey) we'll do scans and discuss more hormonal therapy.

Jim,

Thanks so much for thinking of me. I hope I can make it this year as well. Love to meet you and others from this fine Board. If I come, I'm bringing lots of beer and a cake to celebrate my 50th birthday. It's a milestone of sorts for me. Six years ago, at 44, I seriously thought I would not see it.

about Myers and Provenge: I think I may be able to give a unique perspective on this. I've see him for 3.5 years; 8 visits. Each and every time I saw him I've asked about Provenge. Initially his words were "...not impressed with it...it doesn't reduce PSA, doesn't show any improvements on scan, etc...". The last few times he hasn't been so negative about it. I know for a fact he has put patients on it, but never as a single agent. I think he's excited about the future of immunotherapy in general. He has used Leukine for years. As much as many doctors, etc...think he is sometimes a mad scientist with all his concoctions, I think he generally uses studies and his own years of experience to come up with something that makes sense to treat the individual patient.

Thanks again Jim...talk soon,
Jerry

Tall Allen, unfortunately my husband received the call that he did NOT test positive for the PDL-1. So therefore can not participate in the trial. They invited him to another Phase I Trial, with Extreme High Dose Co-Q10(Ubidecarenone) w/ Doxetaxel. At this point husband is thinking too "risky" as well as one of his Drs. As from we understand Phase 1, is basically testing toxicity in humans for the first time. With his climb in PSA whilst on Lupron, Zytiga and Xtandi triple blocker. Do you think Leikine would be a good try? or is there something else you recommend we could bring up with our Oncologist? He is scheduled for "Restaging" CTs, Labs and Bone Scan mid May. He has never had a PET, would that be good to do? When we asked, we were told no need as that would not change treatment protocol? open to suggestions that we can bring up at his next appt. thank you

Barb,
I'm sorry he didn't get into the trial, but I can't help but think his lack of PD-L1 may be a good thing. It might mean that he can get a very good immune response to another agent. Why is he ineligible for Provenge? It has the same ingredient as Leukine in it, plus a lot more. Here are a few clinical trials you can look into for immunotherapies:

MVA-Brachyury-Tricom - Wash. DC
CYT107±vaccine
Yervoy - NJ & Oregon
anti-PSMA - NY
Provenge with PET/MRI - NY
Provenge +SBRT - Dallas
Provenge±radiation - City of Hope

I very much like Jerry L's suggestion - the Lu-177 is attached to an anti-PSMA antibody, so it has an immune effect as well.

I agree that a PET is unnecessary now - it won't make a difference in his treatment if he finds distant mets in addition to the local ones. However, if the bone scan is negative, a couple of the clinical trials above (the last two) involve radiation to distant mets that may be identified on a PET scan. As LupronJim said, radiation plus immunotherapy may be an optimal combination.

- Allen

Rigby,

That's exactly what Myers told me last week.

Post Edited (Jerry L.) : 4/29/2015 4:14:33 PM (GMT-6)