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Provenge? Anyone scheduled for this treatment?

trainstop
Posts: 2
Joined: Sep 2010

Hope all is well to all. I am scheduled for first Provenge treatment on October 22, 2010, one of three, and am wondering if anyone has experienced or has an appointment for such? My last PSA was 1.58 with Casodex failure, lasted about 5 months, stage IV, with some micrometastatic lesions to upper spine. Not too bad at his point. Have been on Lupron since November, 2008 and surgery in 2002 with a PSA of 2.4. Gleason at biopsy was 3+3, with final 3+4 after surgery. Some discrepancy with Gleason score, as biopsy score was later read by another facility as 4+4. I guess different people interpret the slides with some degree of question. At this point I am counting the days, 31 to go. Will report how this Provenge works out for those of you who may need this later. The Aberaterone trials can't end soon enough for me, and that would be my next choice. We all have to keep the faith that new treatments will be approved at a faster pace since it is a race against time for most of us. Good luck to all, nothing but the best!!!!

mrspjd
Posts: 688
Joined: Apr 2010

trainstop,
Welcome to the PCa forum. Although, we do not have any personal experience with Provenge, we have met one older gentleman in our face to face PCa group who is on Provenge. He appears extremely pleased with the treatment & infusions and touts that he is feeling healthy and doing well--he also looks good! (Hope that helps.) As your post indicated, your PCa is at the T4 stage with some micrometastatic lessions. Wondering what tests were used to locate the lessions (bone scan, mri, etc?), & if you are receiving any type of RT-radiation treatments-such as IMRT or Stereotactic RT, for the lessions. If so, how has it worked out? As you, we've heard that Abiraterone is showing promise in clincial trials. Let's all hope that it will be fast-tracked through the FDA when clinical trials are completed or perhaps sooner, since the current data is so positive. Was it ever an option for you to be in an Abiraterone trial? My husband has T3 locally advanced non-metastasized PCa and is currently in treatment with ADT, HDR-B (completed), and IMRT. If possible, I would encourage you to continue to post your experience here, especially with regard to Provenge.

Wishing you all the best,
mrs pjd

trainstop
Posts: 2
Joined: Sep 2010

September 20, 2010 - 6:53pm
T4 PCa
new
trainstop,
Welcome to the PCa forum. Although, we do not have any personal experience with Provenge, we have met one older gentleman in our face to face PCa group who is on Provenge. He appears extremely pleased with the treatment & infusions and touts that he is feeling healthy and doing well--he also looks good! (Hope that helps.) As your post indicated, your PCa is at the T4 stage with some micrometastatic lessions. Wondering what tests were used to locate the lessions (bone scan, mri, etc?), & if you are receiving any type of RT-radiation treatments-such as IMRT or Stereotactic RT, for the lessions. If so, how has it worked out? As you, we've heard that Abiraterone is showing promise in clincial trials. Let's all hope that it will be fast-tracked through the FDA when clinical trials are completed or perhaps sooner, since the current data is so positive. Was it ever an option for you to be in an Abiraterone trial? My husband has T3 locally advanced non-metastasized PCa and is currently in treatment with ADT, HDR-B (completed), and IMRT. If possible, I would encourage you to continue to post your experience here, especially with regard to Provenge.

Wishing you all the best,
mrs pjd Thanks for the reply and, of course, wishing nothing but the best to you and your husband. My last PSA was in July, this year, and to qualify for Provenge, you must have had hormone failure with a rising PSA. I have both! No steroids, Casodex or other treatment to be administered before the Provenge, as discussed and told to me by my oncologist at DF in Boston. They are treating me systematically rather than isolated therapy such as radiation, which I believe is correct. Recent bone and CT scan showed two small lesions on upper spine about 6-8 inches below the back of one's neck, thoracic region. The problem is these cancers have a mindset of their own and until something shows up, simply one is presumably OK. I had the opportunity to be on the Aberaterone trial, but refused since it was a blind study. To some degree it may have been a better choice than the Casodex, but with Provenge then Aberaterone, hope it is approved soon, which DF seems to be confident it will, I'm beginning to like my chances to prolong a reasonable quality of life somewhat better. In any event, I will post my progression with Provenge as it occurs. 28 days and counting.

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bubos
Posts: 2
Joined: Oct 2010

Dear trainstop,
we have remarkably similar stories- I too am a patient at DF and just last week was approved for Provenge. I will be starting either the last week of this month or first in November. I would love to compare notes as we share this timeline. Let's converse through email to start and my guess is we will cross paths over the coming weeks.
bubos

bryant1212
Posts: 3
Joined: Nov 2010

bubos: I am scheduled for the triple provenge application next month. I would find it helpful to talk to you. I'd appreciate a contact at my email: briary7776@mypacks.net
Good luck with yours. Joe F.

snowmo
Posts: 2
Joined: Oct 2010

Started Provenge 2 weeks ago, getting second time next week. No real problems other than fatique. Definetly feel better. I am current stage 4 and running out of options. Bone pain has subsided

bryant1212
Posts: 3
Joined: Nov 2010

Trainstop: I am scheduled for the triple provenge application next month. I would find it helpful to talk to you. I'd appreciate a contact at my email: briary7776@mypacks.net
Good luck with yours. Joe F.

BEVERLYANN
Posts: 2
Joined: Nov 2010

SERIOUSLY DECIDING WHETHER TO GO WITH PROVENGE VERY SOON. ANYONE KNOW WHAT FOLLOWS PROVENGE. FOR EXAMPLE, IS THAT THE LAST TREATMENT OR DO THEY STILL USE HORMONE TREATMENTS ETC. AFTER WARD?

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VascodaGama
Posts: 1516
Joined: Nov 2010

Hi Beverlyann

It seems that Trainstop does not “stop” here anymore. Many survivors would like to know about experiences on provenge.
I am not taking the drug but I read that you can “move” from immunological therapy (provenge) to hormone or to chemo therapy if the former fails. Dr. Leibowitz is an experienced oncologist for advanced cases and a researcher in HEMATOLOGY. He follows his own protocols that you can read at his team site (http://compassionateoncology.org/).
One of his partners at Compassionate, Dr. Bob has been treating advanced risk patients with a “cocktail” of drugs that include immunologic drugs too. He has published a paper on treatments titled “DR. BOB’S (NOT SO) SECRET RECIPE FOR TREATING
METASTATIC, ADVANCED OR RECURRENT PROSTATE CANCER” which you can read in this site;
http://compassionateoncology.org/pdfs/3-pronged-111908.pdf

I hope you share your experiences with us.

Wishing the above info is of help.
Welcome to the board.
VGama

BEVERLYANN
Posts: 2
Joined: Nov 2010

Thank you. I will check out those 2 websites and if we go forward I will report.

mrspjd
Posts: 688
Joined: Apr 2010

I thought Provenge was used in cases of metastatic castrate resistant, i.e. hormone refractory, disease, where chemotherapy, such as taxotere (docetaxel), has also failed. In other words, if PSA is rising in the context of continued ADT tx, then I believe that would be termed “castrate resistant PCa” (CRPC). Therefore, I’m confused by the recent posts with questions/answers that hormone tx might follow Provenge. Wondering how and why current FDA approved hormone drugs might be used after Provenge tx? ...Unless the hormone tx referred to (following Provenge) might be the not yet FDA approved Abiraterone, assuming it had not already been tried?

Provenge is defined on the manufacturer’s (Dendreon) website as “the first FDA-approved autologous cellular immunotherapy for the treatment of asymptomatic or minimally symptomatic metastatic castrate resistant (hormone refractory) prostate cancer (CRPC).” That website, which you might find helpful, was created to provide basic information to physicians and patients: www.provenge.com

As txs such as Provenge (immunotherapy) and Abiraterone (ADT) continue to show promise in the tx of advanced metastatic disease, I've heard that the future trend in the PCa medical community may be to begin those tx protocols sooner, at earlier stages of disease, such as intermediate risk, with hopes of successful PCa abatement.

BTW, Dr Leibowitz and Dr “Bob” (his nickname) are the same person, i.e. Dr Bob Leibowitz. He is known as a maverick in the PCa medical community and some say that many of his tx protocols for advanced metastatic PCa, while unorthodox, have shown some promise within his own clinical practice and study data; however, to the best of my knowledge, many of those tx findings have not been studied or replicated by other independent sources. That said, I’m sure he’s helped many men with end-stage disease.

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VascodaGama
Posts: 1516
Joined: Nov 2010

Mrs
The partner of Dr. “Bob” Leibowitz is/was Dr. Stephen Tucker (now practicing in Singapore). These doctors have long years of experience in treating PCa patients with a variety of drugs “cocktails”.
Tucker, Leibowitz, Roundy, Myers, Labrie, Scholz, Strum, Lam and colleagues are a “collection” of oncologists, etc. who have given hope successfully to high risk patients in advanced cases as must as in low risk cases. They know well, through years of real facts in the use of many drugs (hormonal, chemo, immune, etc), about drugs side effects, dosages, their inter-reactions and risks.
The cocktails are “fixed” according to principles in balancing interactions/reactions with the enzymes of our systems, and still do the “kill” effectively. Some drugs cause lower count of white blood cells (leukocytes) attacking the immune system functionality, others deprive enzymes from metabolizing still other drugs in the cocktail. Etc, etc, etc.

Many of these drugs have not been approved for a particular type of treatment. Probably the most typical is the ADT3 “cocktail” of drugs (your husband’s protocol), which includes a 5-ARI (finasteride/dutasterine) not approved by FDA for use in prostate cancer but benign cases (recently it has been included in the NCCN Guidelines for the treatment of prostate cancer). Another famous drug in advanced PCa treatment is Ketokanazole which is in fact a drug to treat a variety of skin and fungal infections such as dandruff (Nizoral is its shampoo form).

Both Provenge (immunotherapy) and Abiraterone, are drugs included in the “arsenal” of the above doctors to fight cancer. Expect them to use these new drugs in parallel with Taxotere, Emcyt, Carboplatinum, Leukine, Celebrex, Cytoxan, Revlimid, etc., before, during or after any particular protocol, independently of intermediate or advanced status and their progress.

I have been following studies on Abiraterone which I believe will replace traditional antiandrogens such as Casodex in my close future ADT protocol. Some abstracts by Dr. Oliver Sartor, HT oncologist, and from the research team at the University of Tokyo, comment about still other drugs in the “pipeline”, which will give hope for the many that have failed radical treatments or are confronted with the question similar to the one posted above by Beverlyann (IS THAT THE LAST TREATMENT?).

Many doctors are reluctant in prescribing non approved drugs such as Avodart for PCa cases. They would do it under the "off-label" approach because it makes it easier for them in not assuming the usual load of responsibility
The terminologies used by the various doctors and institutions in fact have the same basic meaning on the status of a patient where HT has failed. Call it; castrate resistant (CRPC). androgen independent (AIPC) or hormone refractory prostate cancer (HRPC), etc.

Hope this helps in your researches.
The best to spj.
VGama

Note; I am not a medical doctor. I have been an avid student researching and studying prostate cancer as a survivor and continuing patient since 2000. (CM)

gottalottodo
Posts: 8
Joined: Oct 2010

i am an MD, not that it helps much as i was a surgeon and critical care specialist, neither of which prepared me at all. i had stage 4 gleason 7 PC diagnosed 7.5 yrs ago. for the first 6, PSA was undetectable. but then it slowly rose to 3.8 at which point Casodex was prescribed. it slowed the rise for 6 months. when Provenge was released, i was considered a candidate as i had asymptomatic metastatic disease. i just completed the 3 infusions [May 13]. i had fatigue, headache and aches and pains. By the 4th or 5th day, i was fine . when PSA reached 16 on Casodex [Apr 20], it was stopped and we waited for the Casodex withdrawal. Not happening - one month later it was 22. Next in line is DES + coumadin to offset the risk of blood clots. I think that it is just something to do until 3 months from the end of Provenge so I can start docetaxel, which must be taken with prednisone, which might interfere with Provenge. As i understand it abiratarone is only FDA approved for use after docetaxel.

I can't say for sure but i am thinking that an individual doctor's decisions are no longer that relevant. between the FDA and the insurance companies, doctors are no longer able to prescribe - - and have insurance companies - - pay for any medication for any use. Of course, you can pay out of pocket! For instance, my wife has MS and has been taking Provigil for 7 years. Two years ago, CVS Caremark who has the contract for medications for the State of CT Insureds decided NOT to pay. we appealed 5 levels including the Attorney General's office. There was not Level 1 or 2 evidence, so their decision was upheld. we buy it in Canada now.
this is my first post, so if i do it wrong, i'd be happy if someone corrected me by e-mail. thanks

bzautry
Posts: 4
Joined: Sep 2011

I would becareful with the DES, as they stopped giving it to women because it causes blood clots.
When I was on it I got a phone call from a friend & I could not say the words I was trying to say.
My wife took me to an emergency clinic & I was admitted & sent to Henry Ford Hospital.Where they ran several tests but couldn`t find any blockage.
the doctor thinks I may have had a blood clot that disolved itself.Although there was no prove of that that may have been caused by the DES.
Woody

gottalottodo
Posts: 8
Joined: Oct 2010

The prior dose to women was 5 mg per day; now it is 1 mg a day plus 1 mg coumadin to try and interfere with clot formation.

gottalottodo
Posts: 8
Joined: Oct 2010

The prior dose to women was 5 mg per day; now it is 1 mg a day plus 1 mg coumadin to try and interfere with clot formation.

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klinefinancial
Posts: 19
Joined: Sep 2001

I had a blood clot on DES ......luckily it was found in my left calf and was able to disolve it with blood thinners......MY wife said it was the worst drug ever as I was most difficult to

get along with.....and emotionally on a roller coaster......lucky for me I had a motorcycle accident and that's how they found the blood clot.

 

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Kongo
Posts: 1167
Joined: Mar 2010

Like MrsPJD I too understood that Provenge was a final treatment drug after cancer had spread to other organs and that the overall extension in life expectancy was about three months. Frankly, after the billons upon billions of dollars spent on research it is disappointing to me that the latest and greatest treatment only prolongs life for a very short period of time at enormous cost.

I do understand that perhaps the knowledge gained from use of the drug at end stages of prostate cancer may lead to additional progress at earlier stages but for most of us with prostae cancer today the liklihood that we would see a benefit from some future breakthrough seems to be slim.

It seems to be that the present research fails to address the underlying causes of cancer in Western nations and instead tries to identify a "silver bullet" that will kill it after the fact. I suspect that the fundamental causes have much more about how we live and what we put into our bodies that feed cancer or create a chemical environment that triggers unchecked cell growth but I see little if any research there. There's no money for the drug companies in having us change our diet to avoid cancer.

K

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VascodaGama
Posts: 1516
Joined: Nov 2010

Yes, Kongo, there is no Silver Bullet yet. None of the treatments available today are good enough to assure the perfect kill. It seems that they focus in treating the wound more than the “fundamental causes”, and we have to endure nasty side effects. Provenge at least gives hope in the class of most advanced cancer patients for an extension of life of about two years (in privileged cases).

I think that genomics hold the “key” to the treatment of cancer. This may be the best shot at spending those billions for a cancer free environment.
I read somewhere that “Tiny differences in the DNA chain can show if a person is prone to disease, or has a life-threatening condition”. BBC has also reported about a fast and low cost DNA test which can determine a person’s chances of developing certain inherited diseases on which prostate cancer seems to belong.

According to the Wall Street Journal (Mar 10/2011), FDA has approved a drug named Benlysta which have been “discovered” from the study of genes and their purposes in the context of the DNA chain. This drug is used to treat the autoimmune disease lupus which affects kidneys, and other organs, and the news say that it is seen as a “milestone in science using genomics in medicine to develop targeted cures”.

Have a look into this report;
“Genetic test in three years to detect prostate cancer”
http://www.guardian.co.uk/science/2008/feb/11/cancer.genetics?INTCMP=ILCNETTXT3487

Three years is an acceptable period to see guys being diagnosed, and that will surely propel immunologic drugs which will aim into “repairing” those uncorrected instructions.

Can we consider this as a “Silver Bullet” ?.

Best to you
VGama

tarhoosier
Posts: 181
Joined: Aug 2006

No.

We have ways to detect Cancer, Prostate and other. The "silver bullet" we need is the treatment for this disease that provides a cure without lingering anxiety of treatment failure. One that works against the disease in all stages. A treatment that can be successful in local and systemic disease. This magic, special, unique drug, this "Eureka" pill is not in the offing.

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Kongo
Posts: 1167
Joined: Mar 2010

Completely

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Kongo
Posts: 1167
Joined: Mar 2010

I agree with tarhoosier on this one, Vasco. The genetic test described in The Guardian is kind of a "so what" to me without more information. We can already detect prostate cancer and we know already those men who at higher risk than others. Waiting three years for a genetic test that only gives us what we know today (with perhaps a marginal increase in specificity) doesn't seem to me that we're making real rapid progress in the genomic aspect of treating cancer.

Now I agree that genome research holds many promises and who knows where it will all lead someday. But we do know today that our lifestyles and diet play a much more direct role in our vulnerability to cancer. Your own experiences in Asia show you that the "secret" is in what we put in our bodies and the statistics from those countries are quite compelling.

K

p.s. I am not understanding what Bynlista has to do with PCa

mrspjd
Posts: 688
Joined: Apr 2010

Vasco,
Thanks for the info. While I'm somewhat aware of a few unorthodox, parallel and combination uses of certain txs for advanced mets PCa, the use of FDA approved ADT following Provenge in CRPC patients is still a little fuzzy to me. But anything is possible.

You’re probably already aware of this, but just to clarify: Nathan Roundy http://www.prostate-cancer.org/pcricms/sites/default/files/PDFs/Is13-2_p2.pdf
and others, such as the renowned PCa advocate, Harry Pinchot (deceased), http://www.prostatecalif.org/files/HarryPinchot.pdf
are lay persons like many of us on this discussion board, with no medical degree or training. They are not oncologists or doctors, but became extremely knowledgeable & self-educated through their own personal experience with, and in depth research about, PCa. Their level of PCa expertise was worthy of earning the respect of many well known medical professionals in the PCa community.

mrspjd
Posts: 688
Joined: Apr 2010

Silver bullet, eureka pill, or magic cure...we can only hope and pray for a PCa causal discovery which might lead to cure, or vice versa. Like the origins of our universe, the best and the brightest minds have long studied theories and have yet to agree on one common causal effect.

It seems more likely that the “answer(s)” is not black and white but instead shades of gray involving the reactions of multiple impinging forces such as DNA, internal and external chemical environment, environmental hazard exposure, diet/food sources, lifestyle choices, etc. that differ with each person. The common element, or more likely, the element combination, may hold the key to opening new scientific doors.

Although the importance of diet/food choices (as well as exercise) is not to be overlooked as a personally manageable/controllable lifestyle option, IMHO, it is unlikely to be the single factor making a difference in proactive cancer awareness & prevention. But that said, it can’t hurt either, and my husband and I are advocates of a heart/PCa healthy diet & lifestyle.

As Kongo writes, it appears that most current research fails to address the underlying causes of cancer/PCa on many levels, deep pocket drug companies, for one. Even though, I have to believe we will continue to see progress, perhaps answers, in our lifetime.

mrs pjd

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Kongo
Posts: 1167
Joined: Mar 2010

I would commend "The China Study" to anyone wondering what might be the underlying causes of cancer and a host of other maladies we in the West suffer from.

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VascodaGama
Posts: 1516
Joined: Nov 2010

My above post was confusing and I am sorry for doing so. Here is my other “Half”.

I believe in genomics as the way to identify the “fundamental causes” of prostate cancer (pointed out by Kongo). And in doing so, genomics can guide researchers in the development of a new treatment (most probably eradicating PCa for good).

This genomic idea began in 1993 with the discovery of the PCA3 gene in the urine which was associated to the prostate cancer by molecular biologist Marion Bussemakers. The urine test (PCA3) makes part of the group of tests used in the diagnosis of prostate cancer, and it is said to be more accurate than our “friendly” PSA which can give false alarms from enlarged benign hyperplasia.

Genetics also play a role in the risk factors for prostate cancer as it is associated to cases of Pca running in members of the same family or in ethnic groups like Western Europeans, Asians and African Americans. Studies based on genetic principles have identified several genetic variants which are contributors to the risk of developing prostate cancer.
I read that “…There are twenty-five genetic variants that are known to increase the risk of developing prostate cancer: seven on chromosome 8 (five of those in the 8q24 region), two on each of the following chromosomes: 2, 3, 7, 11, 17 and 19 and one on each of the following chromosomes: 4, 5, 6, 10, 22 and X".
This means that if those variants are identified in one’s DNA, most probably that person is prone to develop Pca.

Genetic testing for prostate cancer already exits but companies running the “business” are few and the test is very expensive ($500) when compared to the cost of a PSA. (http://www.eyeondna.com/2008/02/12/decode-launches-prca-prostate-cancer-dna-test/)

Logically, very few are doing this test and very few studies exist to produce Tarhoosier’s Eureka pill (the Silver Bullet). The announcement by BBC about a “low cost DNA test” to determine a person’s chances of developing certain inherited diseases, is the light for a hope that we may see Genetics replacing PSA which would be the impulse to studies with sound principles, and therefore, manufacture of directional drugs, identify diets and behaviors.

Benlysta is a drug resulting from a study that identified genetic variants linked to the systemic lupus disease. The cause was the biological activity of B-lymphocyte stimulators that contribute to the production of autoantibodies (antibodies that attack the body’s own healthy tissues).
Drugs to “kill” prostate cancer could be produced on the same principle, as well as it could identify the foods that most contribute in the combat of those risk variants, addressing the problem at earlier stages.

All this genomic identification are based in molecular biology regarding the formation, structure, and function of DNA, RNA and proteins, as well as their roles in the transmission of genetic information. In the “Human Genome System” we know that the genetic “information” encoded in a sequence of the DNA strand, passes to molecules of RNA through a process called transcription. RNA acts as a messenger (mRNA) to pass the information to proteins through a process called translation. The message transcribed from the gene is therefore translated into a protein product that is specialized for a particular function based on the instruction stored in the gene. (lovely study)

Knowing the function of each gene becomes essential to the development of molecular markers and treatments for diseases, such as prostate cancer. More billions should be spent in this line of researches which in my view are in the right direction.
National Cancer Institute has representative videos showing how genetic information is passed and how cancer may develop;
http://www.cancer.gov/newscenter/benchmarks-vol1-issue1/Video ).

I dedicate a toast with red wine to the future of the Genomic affair.

The best to all.
VGama

mrspjd
Posts: 688
Joined: Apr 2010

For anyone interested in reading more about this facinating research, general info on The Human Genome Project can be found at http://www.ornl.gov/sci/techresources/Human_Genome/home.shtml

I'll raise a glass of red to toast w/Vasco & others in hopes that The Genome Project will lead to answers and ultimately, to discoveries, in finding cures for insidious diseases such as PCa.

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VascodaGama
Posts: 1516
Joined: Nov 2010

Gottalottodo

Thanks for sharing with us above your experience with Provenge.
Interaction/reaction between drugs or treatments is really “scaring” as it could lead to drastic consequences. This is where specialists in the treatment of cancer have their “margin” of acknowledge over other doctors. I believe that stage IV cases, no matter in which Gleason pattern the tumour is classified, should be handled with “TARGETED” medications/treatments that by themselves will always require a “balanced” approach. The rate of success is dependent on the experience gained through its application in many cases. Those are the guys that one should trust and give in.

Hormonal treatment is part of that approach, the risks are always there. Treatment needs to be carefully planned, considering other existing health problems and the timely need of additional medications for future arising illnesses or the need of drugs to combat the side effects. This all needs constant vigilance and a methodology previously established.
FDA in fact puts very much “weight” on the matter when deciding on the approval of medications. However, we have seen the reverse to happen, when medications are proved to be efficient in cases to which such approval has not been conceded.

Abiraterone acetate has been on trials in Europe since 2005. Its main principle of action is intertumoral “closing down” the factories of testosterone and avoiding mutations within cells. FDA has approved this drug to be used in refractory prostate cancer but the drug has shown its effectiveness in earlier cases (before mutations take place). I believe that it will become a substitute to anti-agonists in the typical hormonal therapy. Its worse effect is that it interferes with the enzyme CYP450 (c17) which is needed in the metabolism of various drugs.It also interferes with the digestion of food so that it should be taken on an empty stomach.

In the trials of 2007, Abiraterone (CB7630) have shown positive results in patients diagnosed with refractory prostate cancer who have never taken chemotherapy but have taken LHRH analogues and multiple other hormonal therapies, including antiandrogens, diethylstilboestrol and dexamethasone. In the USA Phase II trial results have indicated that the drug benefitted some patients who have used Taxotere (docetaxel) chemotherapy.
This is a drug (Abiraterone) recommended to either before or after chemotherapy.

I wish that you find the best treatment to your advanced case.
Hopefully you will share more of your experience as a MD (surgeon and critical care specialist) in this forum to the wellbeing of all of us in this “boat”.

Thanks.
VGama

gottalottodo
Posts: 8
Joined: Oct 2010

Regarding Zytiga and food interactions, i went to the website and found this:
Food Effect - ZYTIGA must be taken on an empty stomach. Exposure of abiraterone increases up to 10-fold when abiraterone acetate is taken with meals. No food should be eaten for at least two hours before the dose of ZYTIGATM is taken and for at least one hour after the dose of ZYTIGATM is taken.

I also remember reading somewhere else that the absorption of Zytiga depends on the protein, fat and CHO % in the meal. Gee, if they would describe WHAT you should eat, we would be able to take 1/10th as much to get the same amount on board. I wonder why they make us fast and thus have to take [& spend] 10 times as much.

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VascodaGama
Posts: 1516
Joined: Nov 2010

Gottalottodo

I am glad to see another post of yours. I really appreciate your participation in this forum. The majority of survivors in this forum have limited knowledge in medicine and most of our posts are based on own experiences and researches. Our opinions may look like anecdotal to you but we try to share and help each other. We need the expertise of guys like you trained to combat this bandit.

I wonder if you are on Zytiga, for the comment in your post.
In regards to the administration of this drug, I heard that “starving” is the way to assure a coordinated absorption of the drug. It seems that most of the critical side effects are related to poor metabolizing, and liver enzymes must be shared with other functions and drugs. The "mixture" restricts its administration to a series of precautions’ intake.
I call it “The War on the Enzymes”.
Prednisone (a immunosuppressant) is taken in combi with abiraterone and it requires a “collection” of enzymes for the conversion into prednisolone. This steroid fights any inflammation from the "process" of action of abiraterone, (I suppose) when it inhibits CYP17 (17 α-hydroxylase/C17,20-lyase). Immunosuppressants can leave patient temporarily without “defences”. Could food indirectly affect the all system (????).

In Zytiga website they write about drug Interactions like this;
"ZYTIGA is an inhibitor of the hepatic drug-metabolizing enzyme CYP2D6. Avoid co-administration with CYP2D6 substrates that have a narrow therapeutic index. If an alternative cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate. Additionally, abiraterone is a substrate of CYP3A4 in vitro. Strong inhibitors and inducers of CYP3A4 should be avoided or used with caution.” I might be erroneous but it seems that this can indirectly be related to the metabolism of food.

In your position as a MD specialist in critical care cases, I would assume that you have access to detailed pharmacokinetic information from one of your haematologist friend/colleague. Dr. Myers is an extraordinary researcher in this field and uses this kind of “cocktails” in the treatment of advanced prostate cancer. I recall him commenting about the need for constant checks of liver function and other immunologic related conditions (blood), when these type of drugs are “in play”. You could pay him a visit.

Thank you again for sharing your experiences.

Good luck in your journey.

VGama

bzautry
Posts: 4
Joined: Sep 2011

Hi
I have started the treatments,I go tomorrow for the 2nd infusion.
I really can`t tell you alot about it except during the first treatment I had severe chills twice,about 1/2 thru & at the end.They gave me demerol & in a few minutes the chills were gone.
My PSA last month was 16.7 & this month 36.4.from what I have read it takes about 6 months before there is any effect of PSA readings.
woody

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VascodaGama
Posts: 1516
Joined: Nov 2010

Woody

You are one of the few patients on provenge still posting here.
http://csn.cancer.org/node/224218
Could you share some light in regards to your doctor's advice on "prohibitions" while on the treatment?

Is there any particular chemo that patients have taken, which is prohibitive for Provenge?
Is there any medicine which could interfere in Provenge treatment?
Is there any proibition in diet or any particular regimen required for/in guys on Provenge?

Thanks for posting.
Hope your PSA get to the levels you are wishing for.

VGama

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