Abiraterone, Provenge, Chemotherapy

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Jerry L.
Veteran Member


Date Joined Feb 2010
Total Posts : 3072
   Posted 1/2/2011 10:30 PM (GMT -6)   
There are few options after HT, but I'm wondering if drugs like
Abiraterone, Provenge, Chemotherapy can be used one after the other or is it one or the other?
Nov. 2009 Dx at Age 44
Dec. 2009 DaVinci Robotic Surgery
Jan. 2010 T3b, Gleason 9
Feb. 2010 Adjuvant Radiation

PSA History:
-----------------
Nov. 2009 4.30
Feb. 2010 <.05
May 2010 <.05
Aug. 2010 <.05
Nov. 2010 <.05

mycroft
Regular Member


Date Joined Oct 2010
Total Posts : 54
   Posted 1/2/2011 10:44 PM (GMT -6)   
Jerry L. said...
There are few options after HT, but I'm wondering if drugs like
Abiraterone, Provenge, Chemotherapy can be used one after the other or is it one or the other?


I would recommend asking a med onc who is well-trained in tx of PCa.

Sometimes, use of one med precludes use of certain others. There are also certain strict guidelines for enrolling in a clinical trial after using certain meds.
Dx 2004 at 67 yoa: Extensive Gleason 9 + Gleason 8.

Uro wanted to do cryotherapy, which I would have declined had I known anything. It failed, except I was rendered totally impotent; the only thing that worked as advertised.

IMRT + Lupron.

Studied PCa extensively.

Fired rad onc, who refused to read Dr. Strum's evaluation of my case.

Hired med onc. Have been on IADT since 2006.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/3/2011 8:25 AM (GMT -6)   
There are more options than that, most docs don't have the clues on what or when(in later PCa progressions) and that would include some oncologists (uro-docs obviously out of their venue). This is why people seek out Drs.: Sartor, Myers, Scholz, Lam, Volgelzang, Leibowitz among others that are PCa specialists. If you take note of some of these guys therapies used on other patients, they find ways to manipulate therapies to get responses (if at all possible is the goal)....you can be even a failed patient on casodex and is some cases, returning back to it later find it could work again for awhile and in some other cases casodex can actually feed hrpca..so it needs close monitoring on patients. This might happen with other drugs that combat PCa.

The majority of average docs usually have just a couple drug therapies they use, probably because of conservative Hospitals advice from legal staff or because they really don't have clues as to what other stuff might do or not do. So, you get to decide to choose what path do I wish to look into or take, you could even choose darn the torpedos and do your own thing or no drugs...that is your right last time I checked. If you want a warranty program there is none I ever heard of. Howard H. used multiple protocols in fighting his PCa battle and recently passed away...but he did live 17 yrs. is so doing..and even Dr. Meyers and some others commented on his journey as being the first brain mets patient they knew of...likely because the protocols kept PCa at bay sooo long in other parts of the body, that it finally got a chance to start elsewhere in the body.

Examples of other stuff: leukine, (4) estrogenic drug methods(maybe you included that in hormone related therapies already, revlamid, megace, carboplatin, alpharadin (radium 223), MDV3100, Prostvac-vf, Strontuim, Samarium, phenoxodial, dasatinib, ipilimumab, Carbazitaxel (different chemo-new), gleevec, iressa, satraplatin, tarceva, dcvax, xinlay, vitaxin, Ixabepilone, aflibercept, OGX-011, zibotentan (zd4054)-in phase III (might not work too), boron (?), and more. Not to mention combinations of drugs in a therapy useage (Dr. Meyers) and some others have such to offer also. Some failed patients whom went to these kinds of guys found new ways to fight an escalating out of control psa or mets....how long is always the next vista to find out.

Some of the stuff above I would not know much about, but either is being used or has been used on PCa. If you have the Soup Naz_ type doc....he will decide what, when etc. But other docs may want your input or offer you choices (which is the way it should be)... Quite a trip and just about as unknown of a reality as the Twilight Zone, and some of those episodes. Your psa looks excellent right now.

Post Edited (zufus) : 1/3/2011 6:59:28 AM (GMT-7)


cat1111
New Member


Date Joined Jan 2011
Total Posts : 1
   Posted 1/3/2011 11:50 AM (GMT -6)   
+Usually you use one drug after the other to maximize the benefit. The traditional approach has always been chemotherapy after failing hormones. When they realized that the prostate cancer was still sensitive to testosterone after failing the first round of hormones, they created new drugs such as abiraterone and MDV3100. These work similar to the original hormone therapy but target the production of testosterone or the andergon receptor on the genetic and protein level. If these drugs work for you, they can work for an average of 6 months to a few years.
When they examined the effect of MDV3100 on people who had chemo and those who didn't, they found that the drug worked longer if you never took chemo. I would recommend if you haven't had chemo yet looking into MDV3100, there is an open clinical trial, or abiraterone. If and when they stop working then try chemo.
Provenge is recommended to be taken after you fail hormones but before the cancer is growing uncontrollably. It can be taken with abiraterone or MDV3100 or chemo.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/3/2011 12:21 PM (GMT -6)   
Jerry,
It's the $ 64,000 question. Yes they can be but it would be difficult to get them. Right now there is a limit on how many can get Provenge. Pretty much reserved for the guys who really need it. but soon we will have the possibility of using it in the early going. We have no data on how well it may work. And doing the three early? It's all guess work right now.

Hopefully we will see some changes that allow us to find out. Zufus shows us some other possible combinations as does our newest member Cat1111. But again, we lack data on the efficacy of such combinations.

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

tarhoosier
Regular Member


Date Joined Mar 2010
Total Posts : 495
   Posted 1/3/2011 12:51 PM (GMT -6)   
Jerry:
Your question is an excellent one and without a certain answer. The proper sequencing of treatment for any condition or disease is always a choice that makes doctors wonder if they suggested the right thing. The reason that multiple drugs simultaneously is not usually indicated is that one never knows what is working. And if there is success with simultaneous drugs, which should be withdrawn? Or is one reducing or enhancing the effect of another? Medics do not know. The way this is handled in PCa is to use multiple drugs which attack the same target, thus bicalutimide, LHRH injections and Avodart all affect hormone and androgen sources so can be used successfully together. Some doctors agree with this and others prefer a sequence. After this question is addressed then the more common choice is to use the least toxic drug before a more toxic option. Chemo has been tried early in our disease, usually in trials. The results have been disappointing.
There is evidence that Provenge enhances the effect of chemotherapy, thus advancing Provenge to an earlier stage than approved. Dan Petrylak at Columbia U. did this work. There is a trial currently testing abi versus post ketoconazole men to determine the effect for them. Also there is a current trial using abiraterone as the very first treatment, before surgery for men with high risk factors. All this is in flux until the results are in and tested further in the clinic. We do not know. We are using estimates, verified guessing and hope.

windowlite
New Member


Date Joined Feb 2011
Total Posts : 1
   Posted 2/2/2011 6:39 AM (GMT -6)   
Guys ... I've been a shareholder in Dendreon (Provenge) for over 3 yrs now. I found it when I was doing research for my father several yrs ago - for a less or non-toxic alternative to chemo. Provenge was FINALLY approved last April! Men have been able to live and function w/o those horrible side effects! It's just a few days of mild flu-like symptoms. Many men have been living 'years' longer after having taken this immune-stimulating vaccine (not just 4 months!!) This is a whole new paradigm in treating cancer!!! They're paving the way for wonderful new non-toxic therapies that actually make you feel BETTER - NOT 'WORSE' !! I just wish it was available when I was looking for my father's type. Now they're working on Bladder cancer (Phase II trial).

Here are two links (from the Dendreon IV message board) which I had posted the other day both about PROVENGE and also ANOTHER 'pill' Prostate cancer therapy which hasn't had many side effects:

http://www.investorvillage.com/smbd.asp?mb=971&mn=385002&pt=msg&mid=10020904

(video link) *Watch ~~ http://www.urotoday.com/media/presentations/provenge/penson_provenge/player.html

Dr. Penson, Prof. of Urologic Surgery explains he has NO connection to Dendreon, and wants to explain the who, why and how? of PROVENGE!

In the video, Dr. Penson explains that nearly HALF of the men who would be eligible to take Docetaxel - WON'T!..

Only about 50% do ... "However, Docetaxel comes at a price! That price is TOXICITY! " A study by US-2 asked PCr patients about their opinions on taking Chemo. 65% say that it has a negative impact on quality of life and that it's not worth it! "So this again - underscores the need for better treatments,,, etc."

Then he goes on to explain about how Provenge works by stimulating the patients own immune system.
...................................................................................................
Here's the other link for the other treatment I came across. Watch the video on the site by a man who's been living with PC about 8 yrs so far! (Also - look into HIFU therapy !!! ) Best of luck !!! *windowlite

http://www.investorvillage.com/smbd.asp?mb=971&mn=386210&pt=msg&mid=10059560 (the place where I posted the article)

www.lvrj.com/news/clinical-trials-give-cancer-patients-hope-time-114887349.html (the article and video)

Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 2/2/2011 9:33 AM (GMT -6)   
Zufus- I started on Jevtana (Carbazitaxel) last week. Frequency-once every 3 weeks. CT scan after 3 cycles, which works well for me since insurance company approved me for 4 cycles. I'll keep you apprised.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 2/2/2011 10:00 AM (GMT -6)   
Thanks Gordy everybody here would learn something about it and how it may work, it is said to be way better than Docetaxel (taxotere) and worked in some patients whom failed control of psa using that one and got new response on this forum of chemo. It may be all to soon I will be looking over all the other choices on my situation. We can say we are Phd.'s in PCa chemistry, piled high on drugs. There are still other drugs out there, leukine may be one to consider also.
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35, ct and bone scans look clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off 1+ yr., controlled well, resumed, used intermittently, resumed useage

Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 2/2/2011 10:09 AM (GMT -6)   
It's supposed to work particularly well for guys who didn't do well on Taxotere. My problem is that my PSA is still almost undetectable while the cancer continues to grow.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/2/2011 10:26 AM (GMT -6)   
Les,
If you don't mind, can you summarize your trip. We only have it in pieces and you would have so much to say that people here should read...

Love you buddy.

Tony

Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 2/2/2011 10:32 AM (GMT -6)   
Lemme think about that for a bit. It's been 6 years and I didn't start my diary until almost 3 years in.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/2/2011 10:51 AM (GMT -6)   
Good deal! Don't leave out the burnt orange products in your life!

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/17/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 2/2/2011 11:22 AM (GMT -6)   
I have to make an important decision about that item in May and not sure what to do. I've never been so conflicted in this situation.

-Les

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/2/2011 11:28 AM (GMT -6)   
LOL...Send it to Vegas. I promise I'll use Mothers wax on it....

Tony
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