Monday, October 22, 2018

Immunotherapy for Prostate Cancer.
Do They Have It All Wrong?

    There has been a lot of excitement and advertising about the use of Immunotherapy for cancer.
As you may know, Provenge was the first pharmaceutical immunotherapy drug approved by the FDA and also by Medicare for prostate cancer treatment. In fact it was the first of these type drugs approved for any cancer.The concept of re-educating one's immune system to seek and destroy cancer cells with a minimum of side effects is a a great one.
    The original clinical trials were done on men with advanced prostate cancer. In these studies the men involved who took the Provenge were able to extend their lives by about 4 months. Those men in the placebo lived for about 10 months, those on the Provencge lived  for about 14 months
    The trend in treating advancing prostate cancer and in fact all the cancers has been toward individualized protocols. Treatment options are becoming more and more expensive. Provenge for example costs over $100,000 for the cycle. Money well spent if in fact it is effective. We will talk about the financial ramifications in another blog.
But I see a major flaw in the logic as to the "Standard of Care" for treating advanced prostate cancer.
Currently Provenge is used after all other prostate cancer interventions have not successfully stalled the cancer growth. After initial prostate cancer treatment like surgery, radiation, hormonal blockade and chemotherapy are used without success Provenge immunotherapy is used as a last resort. But the majority of medical professionals agree that there interventions, especially chemotherapy, compromise and reduce the natural power of one's immune system.
So why not administer Provenge as a first line treatment when the immune system is still strong and has the best chance for rejuveneation. It seems to me that this approach would have a better chance of success if used at the beginning not at the end of treatment.
We have researched and asked prostate cancer specialists and the pharmaceutical companies why no clinical trials are being done on early stage prostate cancer. No trials appear to be in the works or on the horizon.
What do you think? We would love to hear your thoughts.

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