A patient doesn’t need Provenge if surgery and maybe some follow up radiation does the job.
Provenge is somewhat falling out of favor with the oncologists at MD Anderson. Provenge is for advanced prostate cancer patients. The clinical trials indicated that it extended average survival by only four months. Part of this problem is that it doesn’t really lower PSA or testosterone
Lots of newer ADT (androgen deprivation therapy) drugs, such as Xytiga and Xtandi, can stop progression of metastatic prostate cancer for many years in some cases. I’ve been at it for just over five years now.
I am putting off immunotherapy until my PSA starts rising again, and it won’t be Provenge. There are a number of recent developments and clinical trials with quite a bit of promise with much better results than Provenge.
Jim Allison, PhD, heads up the immunotherapy platform at MD Anderson and the Moon Shot Program. Allison was awarded the Nobel Prize for Medicine for his work on immunotherapy. He pretty much invented the field.
Not to be pedantic, but it was a median 4 month survival advantage, not average 4 month but that is actually significant when you are talking about 86% risk of death in 36 months. But there is more to it than that. The 3-year survival rate was over 30% compared to about 12% for chemo. And, patients who were on the placebo were allowed to cross over to a frozen version of Provenge so in a way it was competing with itself.
This is partly why I said it was approved somewhat controversially. But at the end of the day survival rates cannot be manipulated statistically. Either patients live or they don’t. And in all 3 phase 3 trials Provenge patients lived longer than placebo/crossover/chemo.
I know the drug is out of favor. Personally I think it is just misunderstood.
Look at the in-vivo post hoc data. It basically breaks down into Gleason score quartiles. The people in the lowest Gleason scores quartile perform the best on the drug. The people with the highest scores perform the worst. The theory is that the drug, being an immunotherapy, takes several months to ramp up the immune system. But this is also why you only see a median of 4 months - because this includes all Gleason score patients. If you took only the first quartile Gleason scores (for the uninitiated the lower Gleason score indicates early disease cycle) the survival numbers are much improved.
So like I said, I am not against other drugs and if put in the spot I would take them. For the most part they don’t interfere with Provenge as it is only a 6 week treatment. It’s just a little complicated and expensive and not covered for most people and unfortunately not well understood. But from the data I know, knowing only what I know now (which I admit is limited), I wouldn’t hesitate. But put in the spot I would of course check it all out again I know there are more recently approved drugs and some coming.