What is Immunotherapy And Provenge?

Provenge is a form of immunotherapy that was developed by Dendreon Corporation. Provenge is indicated for metastatic castrate-resistant prostate cancer. So what is that and who is a candidate for Provenge. Metastatic castrate-resistant prostate cancer means prostate cancer that has metastasized out of the prostate, so it may be in someone's lymph nodes or bones which are the two most common places that prostate cancer will metastasize to, so that is metastatic and castrate-resistant means that the prostate cancer no longer is sensitive to the hormone therapy that men are receiving. Most men will get an injection every three, four, or six months that will lower their testosterone to which most cancers are sensitive that will drive the PSA down. In the majority of men who are on hormone therapy for a prolonged period, PSA will start to rise and that's indicating that they are now developing castrate-resistant prostate cancer. So when a man has metastatic castrate-resistant prostate cancer, is now a candidate to receive immunotherapy or Provenge. Provenge is a noble therapy. It is not a chemotherapy or pill that men have to take. It is using a person's own white blood cells. So you will go to a Red Cross Center where a procedure called an apheresis is done and they take white blood cells out of your body and they treat these white blood cells at a company plant where the white cells are incubated with a common protein found on the surface of most prostate cancers called prostatic acid phosphatase. This will sensitize these white blood cells or jump-start them so that when they are infused back into the patient, they will then selectively go and attack the prostate cancer in their body. The procedure is done through three infusions, every two weeks, so it is completed in just under one month. The infusion itself takes an hour in the doctor's office usually and the apheresis is typically done at a Red Cross and could take up to four hours. It's tolerated remarkably well with the most common side effect being chills or fever, sometimes shaking chills, and can be treated with just a warming blanket. We often will give Tylenol if someone gets a headache, but most of these are mild and short lived, not lasting more than a day or two. The results in a large phase III clinical trial in over 500 patients show that in those patients who received Provenge versus those who did not, there was an overall increase in life expectancy of 4.1 months. When you look at the average life expectancy of somebody who has developed metastatic castrate-resistant prostate cancer, it is only about 16 to 19 months. So adding 4.1 months to their overall survival, although, it may not sound like a large number, it is a significant addition and at a low price. It does not negatively impact their quality of life. Men who have metastatic castrate-resistant prostate cancer historically have not had a lot of treatment options. There is a chemotherapy called docetaxel or Taxotere which is administered intravenously every three weeks and can be associated with some pretty nasty, unpleasant side effects such as peripheral neuropathy and neutropenia where your white blood cells will drop. Provenge is much better tolerated and in fact the current NCCN or the National Comprehensive Care Network for prostate cancer guideline recommends Provenge as the first line. It is covered by all Medicare carriers, so in most patients there may at worse be a co-pay associated with receiving Provenge. So if you have got metastatic castrate-resistant prostate cancer, you may be a good candidate to receive Provenge and should bring this up with your urologist. Some prostate cancers are high risk, aggressive, and more likely to spread. Others are low risk, least likely to have bad outcomes. The biopsy says cancer, but correct diagnostic tools provide limited information about how aggressive a man's individual disease is, so most men decide to treat prostate cancer immediately. Once treated, many men experience serious long term side effects, like incontinence and *** impotence. Immediate treatment is not always needed, but right now a man cannot be sure if his cancer is the kind that is likely to require treatment or if he is okay to wait for now. What if there was a test that could determine how aggressive prostate cancer is? Genomic Health is developing a new test to do just that. By reviewing the underlying biology of the tumor and using genes for multiple biologic pathways, the test can predict the aggressiveness of prostate cancer when diagnosed, allowing a man to make a more informed treatment decision with confidence, taking care of himself with more information, and greater peace of mind.