Video: What is Provenge? | Helpline Questions
Helpline Questions | Transcription
Hi I'm Dr. Scholz. A common question we get at the PCRI is what is Provenge?
Provenge is FDA-approved immunotherapy for prostate cancer. It's been on the market for a number of years now it's the first immunotherapy approved for prostate cancer and as of yet is the only one approved. Provenge is a very clever methodology where the immune recognition cells in your blood are removed in a dialysis type process called plasmapheresis at a specialized facility and those cells are then transported to Seal Beach, California and mixed with components that make them recognize and get angry at prostate cancer cells. Once that's accomplished, they're put in the bag sent to the doctor's office and the patient is scheduled to meet when the bag arrives and then that is reinfused. So his own immunotherapy cells are reinfused, but now they're awakened to attack prostate cancer.
When Provenge was originally FDA-approved it actually went through two randomized prospective trials to validate its effectiveness. This is where a third of the people would get a sham infusion, two-thirds would get the real stuff, and consistently both trials showed prolonged survival in the people that got Provenge. The really nice thing about Provenge is that the side-effects from this treatment are quite mild. You may have some fever and chills for a day or you may really feel nothing at all. The other thing is the convenience of administration. Three such visits that I described occur on a Q two week basis and the whole thing is over in four to six weeks.
One of the things that confuses people about Provenge is when you look at most treatments for prostate cancer if the treatments working the PSA drops. With Provenge what seems to be happening is instead of a radical reversal of the disease, the enhanced immune reaction against prostate cancer retards the progression of the disease. So whereas with a lot of chemotherapy poisons or hormone therapy the cancer cells were killed off and then over a period of time they figure out how to handle it then they grow back. With immunotherapy what we often see is that the cancer cells aren't killed off in mass but that they don't grow as well or as quickly after the immune system gets engaged. This question of PSA responses has raised a lot of controversy about Provenge, and perhaps some of that has been dissipated now that there's another life prolonging agent on the market called Xofigo that also does not consistently lower PSA levels. So this idea of retarding the disease progression rather than killing off massive number of cells in mass and then waiting for them to figure out how to grow again is starting to be understood and people are getting more comfortable with the reality that this non-toxic, easy to apply medicine is truly beneficial.
So are all prostate cancer patients eligible for Provenge? Well if you have a lot of money. It's an expensive treatment, but typically insurance companies will cover it in people that have developed some sort of spread outside the prostate—a metastatic lesion—and have become resistant to Lupron. I use Lupron as a it's kind of the Kleenex of hormone therapies—Trelstar, Eligard, Firmagon, Zoladex, and Lupron. All these medicines work by stopping the production of testosterone in the testicles. So if PSA levels are rising, if there's a metastatic lesion somewhere, and you've been on Lupron or a Lupron-like drug your insurance should cover Provenge because it's FDA approved for that type of prostate cancer patient.
So in summary, Provenge is a almost non-toxic very effective and efficacious treatment for prostate cancer. If you haven't heard of it, be aware of it, and particularly if you have a rising PSA on Lupron you should look at the possibility of getting some Provenge to improve your longevity.