Re: Provenge moves forward!

[Guest guest]

Hi Sam

Well I agree that the price and to gain four months does not seem to make sense. My thought about provenge is in my opinion encourageing. I have always believed that the key to our disease is an immunological one. This drug at least for a short time does have a role in making the body realize that cancer is a harmful invader and stimulates an antgen/antibody attack.

Widespread use and refinement may lead to more dramatic results. For me, I would not bankrupt my wife simply to get four months of misery before passing on.

This approach should be widespread clinical trials not a horribly expensive treatment offered to vulnerable desperate people!

Harry

Subject: Provenge moves forward!To: ProstateCancerSupport Date: Thursday, November 18, 2010, 6:47 PM

I guess I must be the only one on this group who is not impressed by this Dendreon - Provenge "adventure". Gaining four months survival at the end of life with Provenge, but still stuck on castration drugs, is not my idea of scientific or medical greatness. You could possibly get as long, maybe more by going on testosterone patches - and have a much happier time of it too !Now, if anyone is excited about Provenge being a money-spinner that is a different matter, and I can see why so many are putting / have put their names to the "Let's all get Provenge OK'd by the FDA".There are other investment goodies coming up, like Alpharadin for instance. But if / when you do your homework you'll see there is no advantage over Metastron. Provenge, like Alpharadin and like Dutasteride a while ago, will generate a lot of froth and the kind of circuitous investment activity that got the whole investment world into trouble a couple of

years ago. The reason: simply because there is no real inherent profit or true social value in this stuff. Compared to a real cure for prostate cancer, or a significant extension of life - years not a handful of months, these market goodies are for the punters, not the patients.This link gives an example of what I am talking about.http://www.nytimes.com/2010/11/18/health/18prostate.html?_r=2 & hpwThere is also a commentary on the Provenge - FDA issue showing just how close Dendreon have cut it. If I were to put my money on anything to do with Dendreon, I'd say they were chasing overheads and losses from 15 years of developing this essentially failed drug. 4 months ? Give us a break !Sam.

[Guest guest]

Sam there are many men who are unimpressed

with Dendreon – Provenge and most of them seem to fail to understand

the difference between a median survival and an overall survival. The

four months ‘improved survival’ commonly referred to in media reports

refer to the median times in the main study. In other words half the men on

Provenge lived four months longer than half the men who were not on Provenge. What

they don’t show, because it gets a bit complicated and doesn’t fit

into a ‘sound bite’ is that the 50% of the men on Provenge who

survived beyond the median significantly outlasted 50% of the men in the

control group and some are still alive today.

When you say <snip> You could

possibly get as long, maybe more by going on testosterone patches <snip> I

say “As long as what? The median survival time? The end time? Do oyu have

any references to support your view that testosterone patches can enhance the

survival of men with T4 aggressive disease? Just interested to know if this is

your opinion or a view backed by any evidence at all.

All the best

Prostate men need enlightening, not frightening

Terry Herbert - diagnosed in 1996 and

still going strong

Read A Strange Place for unbiased information at http://www.yananow.net/StrangePlace/index.html

From:

ProstateCancerSupport [mailto:ProstateCancerSupport ]

On Behalf Of Georgia Sam

Sent: Friday, 19 November 2010

10:48 AM

To:

ProstateCancerSupport

Subject:

Provenge moves forward!

I guess I

must be the only one on this group who is not impressed by this Dendreon -

Provenge " adventure " . Gaining four months survival at the end of life

with Provenge, but still stuck on castration drugs, is not my idea of

scientific or medical greatness. You could possibly get as long, maybe

more by going on testosterone patches - and have a much happier time of it too

!

Now, if anyone is excited about Provenge being a money-spinner that is a

different matter, and I can see why so many are putting / have put their names

to the " Let's all get Provenge OK'd by the FDA " .

There are other investment goodies coming up, like Alpharadin for instance. But

if / when you do your homework you'll see there is no advantage over Metastron.

Provenge, like Alpharadin and like Dutasteride a while ago, will generate a lot

of froth and the kind of circuitous investment activity that got the whole

investment world into trouble a couple of years ago. The reason: simply because

there is no real inherent profit or true social value in this stuff. Compared

to a real cure for prostate cancer, or a significant extension of life - years

not a handful of months, these market goodies are for the punters, not the

patients.

This link gives an example of what I am talking about.

http://www.nytimes.com/2010/11/18/health/18prostate.html?_r=2 & hpw

There is also a commentary on the Provenge - FDA issue showing just how close

Dendreon have cut it. If I were to put my money on anything to do with

Dendreon, I'd say they were chasing overheads and losses from 15 years of

developing this essentially failed drug. 4 months ? Give us a break !

Sam.

[Guest guest]

Harry, Like Sam you seem to have confused

the median survival term with the long term potential. Of half the men on the

Provenge trial died before the median term: but half survived, as did half the

men in the control group. It is what happened after that which should be of

interest.

And on the cost side – if, for example,

Provenge extended life for four or more years – and some of the men are still

alive after that length of time, wht do you estimate the cost would have been

in ADT (Androgen Deprivation Therapy) and Chemotherapy drugs to keep the man

alive that long? Thos don’t come cheaply either.

I’m not defending Provenge – if I had to

pay $93,000 myself for the treatment I wouldn’t like the odds, but then I never

liked the odds for any conventional treatment.

All the best

Terry Herbert

in Melbourne

Australia

Diagnosed ‘96: Age 54: Stage

T2b: PSA 7.2: Gleason 7: No treatment. Jun '07 PSA 42.0 - Bony Metastasis: Aug

'07: Intermittent ADT: PSA 2.3 Aug '10

My site is at

www.prostatecancerwatchfulwaiting.co.za

It is a

tragedy of the world that no one knows what he doesn’t know, and the less a man

knows, the more sure he is that he knows everything. Joyce Carey

From:

ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of Harry Trentes

Sent: Friday, 19 November 2010

11:23 AM

To:

ProstateCancerSupport

Subject: Re:

Provenge moves forward!

Hi Sam

Well I agree that the price and to gain four months

does not seem to make sense. My thought about provenge is in my opinion

encourageing. I have always believed that the key to our disease is an

immunological one. This drug at least for a short time does have a role in

making the body realize that cancer is a harmful invader and stimulates an

antgen/antibody attack.

Widespread use and refinement may lead to more

dramatic results. For me, I would not bankrupt my wife simply to get four

months of misery before passing on.

This approach should be widespread clinical trials

not a horribly expensive treatment offered to vulnerable desperate people!

Harry

Subject: Provenge moves forward!

To: ProstateCancerSupport

Date: Thursday, November 18, 2010, 6:47 PM

I guess I must be the only one on this group who is

not impressed by this Dendreon - Provenge " adventure " . Gaining four

months survival at the end of life with Provenge, but still stuck on

castration drugs, is not my idea of scientific or medical greatness.

You could possibly get as long, maybe more by going on testosterone patches -

and have a much happier time of it too !

Now, if anyone is excited about Provenge being a money-spinner that is a

different matter, and I can see why so many are putting / have put their

names to the " Let's all get Provenge OK'd by the FDA " .

There are other investment goodies coming up, like Alpharadin for instance.

But if / when you do your homework you'll see there is no advantage over

Metastron.

Provenge, like Alpharadin and like Dutasteride a while ago, will generate a

lot of froth and the kind of circuitous investment activity that got the

whole investment world into trouble a couple of years ago. The reason: simply

because there is no real inherent profit or true social value in this stuff.

Compared to a real cure for prostate cancer, or a significant extension of

life - years not a handful of months, these market goodies are for the

punters, not the patients.

This link gives an example of what I am talking about.

http://www.nytimes.com/2010/11/18/health/18prostate.html?_r=2 & hpw

There is also a commentary on the Provenge - FDA issue showing just how close

Dendreon have cut it. If I were to put my money on anything to do with

Dendreon, I'd say they were chasing overheads and losses from 15 years of

developing this essentially failed drug. 4 months ? Give us a break !

Sam.

[Guest guest]

Georgia Sam wrote:

> I guess I must be the only one on this group who is not

> impressed by this Dendreon - Provenge " adventure " . Gaining four

> months survival at the end of life with Provenge, but still

> stuck on castration drugs, is not my idea of scientific or

> medical greatness. You could possibly get as long, maybe more

> by going on testosterone patches - and have a much happier time

> of it too !

Sam,

I understand that point of view, and it makes some sense, but I

am impressed by Provenge for a number of reasons:

1. As Terry says, some men will have a response that is better,

and maybe even much better, than the average response.

2. Provenge has only been tried on men who have failed

conventional therapy, including ADT and chemotherapy. This

may be too late to get the greatest benefit from the process.

It may turn out that it will be dramatically more successful

if and when it is tried earlier.

3. Provenge has few undesirable side effects.

It appears to be easier to tolerate than chemo and may even

be easier than ADT.

4. The approach taken by Provenge is revolutionary.

Dendreon is not the only company working on this approach and

PCa is not the only cancer that might benefit from it.

Immunotherapy for cancer is very new, relatively speaking.

It has nothing in common with either hormone or chemo

therapy. It is a completely different technique for treating

cancer.

Provenge is just the first shot at immunotherapy for PCa,

just as physical castration was the first shot at hormone

therapy.

It may turn out that experience with Provenge will enable

Dendreon and other companies and research centers to develop

better immunotherapies for the future.

5. Provenge may work better in combination with other therapies.

The scientific community is learning, largely from pediatric

cancers, that combining multiple powerful drugs with

different mechanisms of action sometimes completely cures

cancers that were thought to be incurable.

Hormone therapy, chemotherapy and immunotherapy seem to all

kill overlapping but different populations of tumor cells.

Using all together, before the cancer has become resistant to

any one of them, may get us closer to a cure. Maybe it could

be a real cure for at least some patients. Maybe all of the

drugs we have, taken with just one or two more partial cures,

will be the magic potion that starts to cure the incurables.

> http://www.nytimes.com/2010/11/18/health/18prostate.html?_r=2 & hpw

That looks very promising. It's always possible that that new

drug, or some other new drug, will cure PCa and eliminate all

other therapies. If that happens, great! But I don't want give

up all the helpful drugs now on the speculation that a cure is

around the corner. Maybe, if a breakthrough drug arrives,

Provenge will have kept some people alive long enough that

they'll live to walk around that corner.

It may also be that the new drug works well, but isn't quite a

cure, but when taken with ADT, chemo, and immunotherapy all at

once, it really cures people (point 5 above.)

One thing I've learned from reading biochemistry and molecular

biology is that cancer research is really, really hard. It makes

rocket science look easy. A cancerous cell has many tens of

thousands of different molecules and molecular sequences, tens of

thousands of biochemical pathways. All of them existing at a

deep submicroscopic level, hidden away from observation, inside

living tissues that, if you take them apart to see what's going

on, immediately die and halt all of the processes you're trying

to observe. And even if you learn everything about one of the

cells, which might not be achieved for hundreds of years, it

turns out that different cells in the same patient often have

different disease characteristics.

It's easy for us to criticize the scientists for not coming up

with cures, but my hat is off to them for the great progress that

they are making with a disease that, until the middle of the last

century, _nobody_ knew how to do _anything_ about.

Alan

[Guest guest]

On 11/18/10, Alan Meyer replied to Sammy:

>

> I understand that point of view, and it makes some sense, but I

> am impressed by Provenge for a number of reasons:

>

> 1. As Terry says, some men will have a response that is better,

> and maybe even much better, than the average response.

Et cetera.

In other words, what is reported is the *median* response, and

median does not equal average. Even Sammy knows that; or should.

The median amount is that which 50% of the population exceeds,

and 50% does not.

Furthermore, as in the case of the Taxotere / docetaxel trials,

the test populations were, as my oncologist and I have agreed, on

their last legs and had no hope. Brave unselfish men to whom we

owe much.

Consequently, anyone who is NOT on their last legs without hope

should be able to anticipate a result that is better than median.

Somehow, this simple idea seems to have escaped may of our brothers.

[Guest guest]

Good points made here. And I suspect the ultimate use might be using Provenge or

a similar drug soon after primary treatment to eliminate any residual cells.

Testing the actual cancer cells just after surgery and treating them might

really increase the odds of a cure.

[Guest guest]



Ho Hum. I am sorry guys but all this Provenge twitter is just more about tinkering around the edges. After the expenditure of Billions (with a capital this is the best they can do? How about a cure? NASA put a man on the moon, but it seems our cancer research efforts could not get us on the crosstown bus.

"Lord, what fools these mortals be!" Shakespeare, "A Midsummer Night's Dream", Act 3 scene 2

Provenge moves forward!To: ProstateCancerSupport Date: Thursday, November 18, 2010, 6:47 PM

I guess I must be the only one on this group who is not impressed by this Dendreon - Provenge "adventure". Gaining four months survival at the end of life with Provenge, but still stuck on castration drugs, is not my idea of scientific or medical greatness. You could possibly get as long, maybe more by going on testosterone patches - and have a much happier time of it too !Now, if anyone is excited about Provenge being a money-spinner that is a different matter, and I can see why so many are putting / have put their names to the "Let's all get Provenge OK'd by the FDA".There are other investment goodies coming up, like Alpharadin for instance. But if / when you do your homework you'll see there is no advantage over Metastron. Provenge, like Alpharadin and like Dutasteride a while ago, will generate a lot of froth and the kind of circuitous investment activity that got the whole investment world into trouble a couple of years ago. The reason: simply because there is no real inherent profit or true social value in this stuff. Compared to a real cure for prostate cancer, or a significant extension of life - years not a handful of months, these market goodies are for the punters, not the patients.This link gives an example of what I am talking about.http://www.nytimes.com/2010/11/18/health/18prostate.html?_r=2 & hpwThere is also a commentary on the Provenge - FDA issue showing just how close Dendreon have cut it. If I were to put my money on anything to do with Dendreon, I'd say they were chasing overheads and losses from 15 years of developing this essentially failed drug. 4 months ? Give us a break !Sam.

[Guest guest]

Baby steps .

 

Sure I'd like a cure too. I have a few less years under my belt than most of you and therefore have a few more unfulfilled dreams and wants to complete. Maybe Provenge gives me a few years, who knows? What I do know is this; if I were to receive it (it is very likely my next treatment) I am VERY confident I'll out live the 'average'.

 

How do I know?

- 'Statistics' told me when I was first diagnosed that I had 36 months to live. That was 58 months ago.

Our friend 'Statistics' also told me this medicine would last x long and that one would last longer. Neither prediction was correct.

If/when I take Provenge and it stops working I know there a other options out there. A cure? No, not yet. In all likelihood not in my short lifetime either.

 

Provenge is getting beat up here and other places for the price. This is sure to come down. The first decline will come when Medicare announces their reimbursement rate and that will ripple through the insurance industry. Will it be cheap? Certainly not. I still haven't seen an accurate comaparison to a cycle of 6-8 Taxotere treatments? A fair comparison, not just the cost of Tax, but an all inclusive cost of tests, scans etc.

 

On another but related note, where's the outrage over Amgen's announcement yesterday regarding Denosumab? The FDA approves the drug and in one of the news stories it specifically states that the cost is double that of Zometa with NO increased benefit!

Sorry for the rant. I don't do this too often and I send this with the utmost respect for your opinions and everyone else's. The entire situation is terribly frustrating at times!

 

davide

 

 

 Ho Hum. I am sorry guys but all this Provenge twitter is just more about tinkering around the edges. After the expenditure of Billions (with a capital this is the best they can do? How about a cure? NASA put a man on the moon, but it seems our cancer research efforts could not get us on the crosstown bus.

 

 

" Lord, what fools these mortals be! " Shakespeare, " A Midsummer Night's Dream " , Act 3 scene 2

Provenge moves forward!

To: ProstateCancerSupport Date: Thursday, November 18, 2010, 6:47 PM

 

I guess I must be the only one on this group who is not impressed by this Dendreon - Provenge " adventure " . Gaining four months survival at the end of life with Provenge, but still stuck on castration drugs, is not my idea of scientific or medical greatness.  You could possibly get as long, maybe more by going on testosterone patches - and have a much happier time of it too !

Now, if anyone is excited about Provenge being a money-spinner that is a different matter, and I can see why so many are putting / have put their names to the " Let's all get Provenge OK'd by the FDA " .

There are other investment goodies coming up, like Alpharadin for instance. But if / when you do your homework you'll see there is no advantage over Metastron. Provenge, like Alpharadin and like Dutasteride a while ago, will generate a lot of froth and the kind of circuitous investment activity that got the whole investment world into trouble a couple of years ago. The reason: simply because there is no real inherent profit or true social value in this stuff. Compared to a real cure for prostate cancer, or a significant extension of life - years not a handful of months, these market goodies are for the punters, not the patients.

This link gives an example of what I am talking about. http://www.nytimes.com/2010/11/18/health/18prostate.html?_r=2 & hpw

There is also a commentary on the Provenge - FDA issue showing just how close Dendreon have cut it. If I were to put my money on anything to do with Dendreon, I'd say they were chasing overheads and losses from 15 years of developing this essentially failed drug. 4 months ? Give us a break !

Sam.

-- Emersonwww.flhw.org

Every 2.25 minutes a man is diagnosed with prostate cancer.Every 16.5 minutes a man dies from the disease.

[Guest guest]



wrote:<snip> " A cure? No, not yet. In all likelihood not in my short lifetime either."<snip>

I hope you are wrong about this but how many patients lifetimes will it take? Any statistics on that. I will take some liberty here and say that the medical profession has been pursuing a cure for cancer, any variety, for two hundred years at a cost of trillions of dollars, pounds, drachmas pesos, whatever. And if a doctor were a car mechanic his tool box would contain a hammer, a larger hammer, seven oil cans with various labels, hacksaws, robotic hacksaws, right angle hacksaws, a couple of blowtorches, some dry ice, and five different types of epoxy cement. That's it! That is all they have to fix your $60,000 Mercedes.

What is wrong? I wish I had better answers to that but I do think that when new discoveries are made the reporting is often directed at those who would most stand to gain monetarily. Wall Street loves Dendreon. For me, not so much.

"Il faut d'abord durer" Hemingway

Re: Provenge moves forward!

Baby steps .

Sure I'd like a cure too. I have a few less years under my belt than most of you and therefore have a few more unfulfilled dreams and wants to complete. Maybe Provenge gives me a few years, who knows? What I do know is this; if I were to receive it (it is very likely my next treatment) I am VERY confident I'll out live the 'average'.

How do I know?

- 'Statistics' told me when I was first diagnosed that I had 36 months to live. That was 58 months ago.

Our friend 'Statistics' also told me this medicine would last x long and that one would last longer. Neither prediction was correct.

If/when I take Provenge and it stops working I know there a other options out there. A cure? No, not yet. In all likelihood not in my short lifetime either.

Provenge is getting beat up here and other places for the price. This is sure to come down. The first decline will come when Medicare announces their reimbursement rate and that will ripple through the insurance industry. Will it be cheap? Certainly not. I still haven't seen an accurate comaparison to a cycle of 6-8 Taxotere treatments? A fair comparison, not just the cost of Tax, but an all inclusive cost of tests, scans etc.

On another but related note, where's the outrage over Amgen's announcement yesterday regarding Denosumab? The FDA approves the drug and in one of the news stories it specifically states that the cost is double that of Zometa with NO increased benefit!

Sorry for the rant. I don't do this too often and I send this with the utmost respect for your opinions and everyone else's. The entire situation is terribly frustrating at times!

davide

 Ho Hum. I am sorry guys but all this Provenge twitter is just more about tinkering around the edges. After the expenditure of Billions (with a capital this is the best they can do? How about a cure? NASA put a man on the moon, but it seems our cancer research efforts could not get us on the crosstown bus.

"Lord, what fools these mortals be!" Shakespeare, "A Midsummer Night's Dream", Act 3 scene 2

[Guest guest]

Where can I get a Mercedes for $60k?

OK, just kidding ;-)

Your point is well taken. I'm Switzerland regarding Dendreon,neither friend nor foe. I am anxious to see further trials of Provenge in a variety of situations. Pre-post different chemos, radiation, ADT varieties etc.

 

Finally, remember one of the first PCa treatments and one that remains in some instances today is an Orchechtomy!

 

 wrote:<snip> " A cure? No, not yet. In all likelihood not in my short lifetime either. " <snip>

 

I hope you are wrong about this but how many patients lifetimes will it take? Any statistics on that. I will take some liberty here and say that the medical profession has been pursuing a cure for cancer, any variety, for two hundred years at a cost of trillions of dollars, pounds, drachmas pesos, whatever. And if a doctor were a car mechanic his tool box would contain a hammer, a larger hammer, seven oil cans with various labels, hacksaws, robotic hacksaws, right angle hacksaws, a couple of blowtorches, some dry ice, and five different types of epoxy cement. That's it! That is all they have to fix your $60,000 Mercedes.  

 

What is wrong? I wish I had better answers to that but I do think that when new discoveries are made the reporting is often directed at those who would most stand to gain monetarily. Wall Street loves Dendreon. For me, not so much.

 

" Il faut d'abord durer "    Hemingway

Re: Provenge moves forward!

Baby steps .

 

Sure I'd like a cure too. I have a few less years under my belt than most of you and therefore have a few more unfulfilled dreams and wants to complete. Maybe Provenge gives me a few years, who knows? What I do know is this; if I were to receive it (it is very likely my next treatment) I am VERY confident I'll out live the 'average'.

 

How do I know?

- 'Statistics' told me when I was first diagnosed that I had 36 months to live. That was 58 months ago.

Our friend 'Statistics' also told me this medicine would last x long and that one would last longer. Neither prediction was correct.

If/when I take Provenge and it stops working I know there a other options out there. A cure? No, not yet. In all likelihood not in my short lifetime either.

 

Provenge is getting beat up here and other places for the price. This is sure to come down. The first decline will come when Medicare announces their reimbursement rate and that will ripple through the insurance industry. Will it be cheap? Certainly not. I still haven't seen an accurate comaparison to a cycle of 6-8 Taxotere treatments? A fair comparison, not just the cost of Tax, but an all inclusive cost of tests, scans etc.

 

On another but related note, where's the outrage over Amgen's announcement yesterday regarding Denosumab? The FDA approves the drug and in one of the news stories it specifically states that the cost is double that of Zometa with NO increased benefit!

Sorry for the rant. I don't do this too often and I send this with the utmost respect for your opinions and everyone else's. The entire situation is terribly frustrating at times!

 

davide

 

 

 Ho Hum. I am sorry guys but all this Provenge twitter is just more about tinkering around the edges. After the expenditure of Billions (with a capital this is the best they can do? How about a cure? NASA put a man on the moon, but it seems our cancer research efforts could not get us on the crosstown bus.

 

 

" Lord, what fools these mortals be! " Shakespeare, " A Midsummer Night's Dream " , Act 3 scene 2

 

-- Emersonwww.flhw.org

Every 2.25 minutes a man is diagnosed with prostate cancer.Every 16.5 minutes a man dies from the disease.

[Guest guest]



Kathy wrote:<snip> "Because this is so complex it is important to read broadly and understand the system before decisions are made."<snip>

I cannot disagree Kathy but I have begun to have a little cynicism creep into my opinions of the "search for a cure" effort. More and more it resembles a game played with three walnut shells and a pea. Maybe age nurtures cynicism. Maybe not. I have never been this age before. I will keep searching.

Ever try?Ever fail?No matter.Try again.Fail again.Fail better. Beckett

RE: Provenge moves forward!

I think what we have rather than a cure is that cancer is becoming more of a chronic disease for more and more men and women. While there may not be a magic bullet what we have done is to extend people’s lifetime with sequential treatments. Don’t think anyone would want to go back to the old days with so few options and limited understanding of the biology.

In the beginning I don’t think anyone understood how difficult the biology was. Unlike other diseases cancer wants to stay viable and changes(mets). That is why we should all be learning about research so that we have realistic expectations.

Also the cost of chemo is often more expensive than Provenge. Should we say that chemo is too expensive? How do we realistically control costs? Fortunately not all men with prostate cancer will be faced with the dilemma of what to do about advanced prostate cancer. 50% of the people who participated in the Provenge clinical trials took chemo after the trial ended. Was that necessary or a choice? Do we design trials that tell men that once they receive the treatment they cannot have a second treatment? What happened to the men who did not have chemo? Did they die or did they live with disease in remission? Dendreon has set up a registry to try to get answers to these questions. The panel at the CMS meeting discussed a tissue repository to help identify which men responded and why. More money is necessary for this. Means also more money needs to be spent on treatment markers.

Cost effective discussions are always difficult especially in this time of potential diminishing research funding. Each new novel treatment moves us forward and the more men who have the treatment in the clinical setting the more information we will have and the better the research may be in the future. They have already learned many new things about prostate cancer and vaccines and that all helps to move future exploration forward that began with Provenge.

What should our treatment and research funding priorities be? Some believe that the bulk of the money should go to prevention research. Others believe that basic science is most important. Should we be focusing on early detection markers? Treatment markers? Research markers? May not all be the same thing.

Because this is so complex it is important to read broadly and understand the system before decisions are made.

Kathy Meade

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of KennedySent: Friday, November 19, 2010 8:36 AMTo: ProstateCancerSupport Subject: Re: Provenge moves forward!



wrote:<snip> " A cure? No, not yet. In all likelihood not in my short lifetime either."<snip>

I hope you are wrong about this but how many patients lifetimes will it take? Any statistics on that. I will take some liberty here and say that the medical profession has been pursuing a cure for cancer, any variety, for two hundred years at a cost of trillions of dollars, pounds, drachmas pesos, whatever. And if a doctor were a car mechanic his tool box would contain a hammer, a larger hammer, seven oil cans with various labels, hacksaws, robotic hacksaws, right angle hacksaws, a couple of blowtorches, some dry ice, and five different types of epoxy cement. That's it! That is all they have to fix your $60,000 Mercedes.

What is wrong? I wish I had better answers to that but I do think that when new discoveries are made the reporting is often directed at those who would most stand to gain monetarily. Wall Street loves Dendreon. For me, not so much.

"Il faut d'abord durer" Hemingway

[Guest guest]

I think what we have rather than a cure is that cancer is becoming more of a chronic disease for more and more men and women. While there may not be a magic bullet what we have done is to extend people’s lifetime with sequential treatments. Don’t think anyone would want to go back to the old days with so few options and limited understanding of the biology. In the beginning I don’t think anyone understood how difficult the biology was. Unlike other diseases cancer wants to stay viable and changes(mets). That is why we should all be learning about research so that we have realistic expectations. Also the cost of chemo is often more expensive than Provenge. Should we say that chemo is too expensive? How do we realistically control costs? Fortunately not all men with prostate cancer will be faced with the dilemma of what to do about advanced prostate cancer.  50% of the people who participated in the Provenge clinical trials took chemo after the trial ended. Was that necessary or a choice? Do we design trials that tell men that once they receive the treatment they cannot have a second treatment? What happened to the men who did not have chemo? Did they die or did they live with disease in remission? Dendreon has set up a registry to try to get answers to these questions. The panel at the CMS meeting discussed a tissue repository to help identify which men responded and why. More money is necessary for this.  Means also more money needs to be spent on treatment markers. Cost effective discussions are always difficult especially in this time of potential diminishing research funding. Each new novel treatment moves us forward and the more men who have the treatment in the clinical setting the more information we will have and the better the research may be in the future. They have already learned many new things about prostate cancer and vaccines and that all helps to move future exploration forward that began with Provenge. What should our treatment and research funding priorities be? Some believe that the bulk of the money should go to prevention research. Others believe that basic science is most important. Should we be focusing on early detection markers? Treatment markers? Research markers? May not all be the same thing. Because this is so complex it is important to read broadly and understand the system before decisions are made. Kathy Meade From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of KennedySent: Friday, November 19, 2010 8:36 AMTo: ProstateCancerSupport Subject: Re: Provenge moves forward!  wrote:<snip> " A cure? No, not yet. In all likelihood not in my short lifetime either. " <snip> I hope you are wrong about this but how many patients lifetimes will it take? Any statistics on that. I will take some liberty here and say that the medical profession has been pursuing a cure for cancer, any variety, for two hundred years at a cost of trillions of dollars, pounds, drachmas pesos, whatever. And if a doctor were a car mechanic his tool box would contain a hammer, a larger hammer, seven oil cans with various labels, hacksaws, robotic hacksaws, right angle hacksaws, a couple of blowtorches, some dry ice, and five different types of epoxy cement. That's it! That is all they have to fix your $60,000 Mercedes. What is wrong? I wish I had better answers to that but I do think that when new discoveries are made the reporting is often directed at those who would most stand to gain monetarily. Wall Street loves Dendreon. For me, not so much. " Il faut d'abord durer " Hemingway Re: Provenge moves forward! Baby steps . Sure I'd like a cure too. I have a few less years under my belt than most of you and therefore have a few more unfulfilled dreams and wants to complete. Maybe Provenge gives me a few years, who knows? What I do know is this; if I were to receive it (it is very likely my next treatment) I am VERY confident I'll out live the 'average'. How do I know? - 'Statistics' told me when I was first diagnosed that I had 36 months to live. That was 58 months ago.Our friend 'Statistics' also told me this medicine would last x long and that one would last longer. Neither prediction was correct. If/when I take Provenge and it stops working I know there a other options out there. A cure? No, not yet. In all likelihood not in my short lifetime either. Provenge is getting beat up here and other places for the price. This is sure to come down. The first decline will come when Medicare announces their reimbursement rate and that will ripple through the insurance industry. Will it be cheap? Certainly not. I still haven't seen an accurate comaparison to a cycle of 6-8 Taxotere treatments? A fair comparison, not just the cost of Tax, but an all inclusive cost of tests, scans etc. On another but related note, where's the outrage over Amgen's announcement yesterday regarding Denosumab? The FDA approves the drug and in one of the news stories it specifically states that the cost is double that of Zometa with NO increased benefit! Sorry for the rant. I don't do this too often and I send this with the utmost respect for your opinions and everyone else's. The entire situation is terribly frustrating at times! davide  Ho Hum. I am sorry guys but all this Provenge twitter is just more about tinkering around the edges. After the expenditure of Billions (with a capital this is the best they can do? How about a cure? NASA put a man on the moon, but it seems our cancer research efforts could not get us on the crosstown bus. " Lord, what fools these mortals be! " Shakespeare, " A Midsummer Night's Dream " , Act 3 scene 2

[Guest guest]

Kathy, will look that over tonight.

- I like to think of myself as 'optimistically cynical'!

 

, A friend who spoke at the CMS hearing pulled all his bills for chemo and chemo related meds/ER/transfusions, etc for the past 11 months and it came out to over the price of Provenge. He had it broken down by the item.

 

I hate the money that goes into “me too†drugs. Just posted something on the VPCC Facebook page related to that issue that you might want to read.

 

Kathy

 

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Emerson

Sent: Friday, November 19, 2010 7:07 AM To: ProstateCancerSupport Subject: Re: Provenge moves forward!

 

 

Baby steps .

 

Sure I'd like a cure too. I have a few less years under my belt than most of you and therefore have a few more unfulfilled dreams and wants to complete. Maybe Provenge gives me a few years, who knows? What I do know is this; if I were to receive it (it is very likely my next treatment) I am VERY confident I'll out live the 'average'.

 

How do I know?

- 'Statistics' told me when I was first diagnosed that I had 36 months to live. That was 58 months ago.

Our friend 'Statistics' also told me this medicine would last x long and that one would last longer. Neither prediction was correct.

If/when I take Provenge and it stops working I know there a other options out there. A cure? No, not yet. In all likelihood not in my short lifetime either.

 

Provenge is getting beat up here and other places for the price. This is sure to come down. The first decline will come when Medicare announces their reimbursement rate and that will ripple through the insurance industry. Will it be cheap? Certainly not. I still haven't seen an accurate comaparison to a cycle of 6-8 Taxotere treatments? A fair comparison, not just the cost of Tax, but an all inclusive cost of tests, scans etc.

 

On another but related note, where's the outrage over Amgen's announcement yesterday regarding Denosumab? The FDA approves the drug and in one of the news stories it specifically states that the cost is double that of Zometa with NO increased benefit!

Sorry for the rant. I don't do this too often and I send this with the utmost respect for your opinions and everyone else's. The entire situation is terribly frustrating at times!

 

davide

 

 



Ho Hum. I am sorry guys but all this Provenge twitter is just more about tinkering around the edges. After the expenditure of Billions (with a capital this is the best they can do? How about a cure? NASA put a man on the moon, but it seems our cancer research efforts could not get us on the crosstown bus.

 

 

" Lord, what fools these mortals be! " Shakespeare, " A Midsummer Night's Dream " , Act 3 scene 2

Provenge moves forward!To: ProstateCancerSupport

Date: Thursday, November 18, 2010, 6:47 PM

 

I guess I must be the only one on this group who is not impressed by this Dendreon - Provenge " adventure " . Gaining four months survival at the end of life with Provenge, but still stuck on castration drugs, is not my idea of scientific or medical greatness.  You could possibly get as long, maybe more by going on testosterone patches - and have a much happier time of it too !

Now, if anyone is excited about Provenge being a money-spinner that is a different matter, and I can see why so many are putting / have put their names to the " Let's all get Provenge OK'd by the FDA " .

There are other investment goodies coming up, like Alpharadin for instance. But if / when you do your homework you'll see there is no advantage over Metastron. Provenge, like Alpharadin and like Dutasteride a while ago, will generate a lot of froth and the kind of circuitous investment activity that got the whole investment world into trouble a couple of years ago. The reason: simply because there is no real inherent profit or true social value in this stuff. Compared to a real cure for prostate cancer, or a significant extension of life - years not a handful of months, these market goodies are for the punters, not the patients.

This link gives an example of what I am talking about.

http://www.nytimes.com/2010/11/18/health/18prostate.html?_r=2 & hpw

There is also a commentary on the Provenge - FDA issue showing just how close Dendreon have cut it. If I were to put my money on anything to do with Dendreon, I'd say they were chasing overheads and losses from 15 years of developing this essentially failed drug. 4 months ? Give us a break !

Sam.

 

-- Emersonwww.flhw.orgEvery 2.25 minutes a man is diagnosed with prostate cancer.

Every 16.5 minutes a man dies from the disease.

-- Emersonwww.flhw.org

Every 2.25 minutes a man is diagnosed with prostate cancer.Every 16.5 minutes a man dies from the disease.

[Guest guest]

, Cynicism is a good thing. Can makes you look more deeply into the subject. Just because you read or hear it doesn’t mean that it true.  Means you have to look further. Kathy From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of KennedySent: Friday, November 19, 2010 11:00 AMTo: ProstateCancerSupport Subject: Re: Provenge moves forward!  Kathy wrote:<snip> " Because this is so complex it is important to read broadly and understand the system before decisions are made. " <snip> I cannot disagree Kathy but I have begun to have a little cynicism creep into my opinions of the " search for a cure " effort. More and more it resembles a game played with three walnut shells and a pea. Maybe age nurtures cynicism. Maybe not. I have never been this age before. I will keep searching. Ever try?Ever fail?No matter.Try again.Fail again.Fail better. Beckett RE: Provenge moves forward! I think what we have rather than a cure is that cancer is becoming more of a chronic disease for more and more men and women. While there may not be a magic bullet what we have done is to extend people’s lifetime with sequential treatments. Don’t think anyone would want to go back to the old days with so few options and limited understanding of the biology. In the beginning I don’t think anyone understood how difficult the biology was. Unlike other diseases cancer wants to stay viable and changes(mets). That is why we should all be learning about research so that we have realistic expectations. Also the cost of chemo is often more expensive than Provenge. Should we say that chemo is too expensive? How do we realistically control costs? Fortunately not all men with prostate cancer will be faced with the dilemma of what to do about advanced prostate cancer. 50% of the people who participated in the Provenge clinical trials took chemo after the trial ended. Was that necessary or a choice? Do we design trials that tell men that once they receive the treatment they cannot have a second treatment? What happened to the men who did not have chemo? Did they die or did they live with disease in remission? Dendreon has set up a registry to try to get answers to these questions. The panel at the CMS meeting discussed a tissue repository to help identify which men responded and why. More money is necessary for this. Means also more money needs to be spent on treatment markers. Cost effective discussions are always difficult especially in this time of potential diminishing research funding. Each new novel treatment moves us forward and the more men who have the treatment in the clinical setting the more information we will have and the better the research may be in the future. They have already learned many new things about prostate cancer and vaccines and that all helps to move future exploration forward that began with Provenge. What should our treatment and research funding priorities be? Some believe that the bulk of the money should go to prevention research. Others believe that basic science is most important. Should we be focusing on early detection markers? Treatment markers? Research markers? May not all be the same thing. Because this is so complex it is important to read broadly and understand the system before decisions are made. Kathy Meade From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of KennedySent: Friday, November 19, 2010 8:36 AMTo: ProstateCancerSupport Subject: Re: Provenge moves forward!  wrote:<snip> " A cure? No, not yet. In all likelihood not in my short lifetime either. " <snip> I hope you are wrong about this but how many patients lifetimes will it take? Any statistics on that. I will take some liberty here and say that the medical profession has been pursuing a cure for cancer, any variety, for two hundred years at a cost of trillions of dollars, pounds, drachmas pesos, whatever. And if a doctor were a car mechanic his tool box would contain a hammer, a larger hammer, seven oil cans with various labels, hacksaws, robotic hacksaws, right angle hacksaws, a couple of blowtorches, some dry ice, and five different types of epoxy cement. That's it! That is all they have to fix your $60,000 Mercedes. What is wrong? I wish I had better answers to that but I do think that when new discoveries are made the reporting is often directed at those who would most stand to gain monetarily. Wall Street loves Dendreon. For me, not so much. " Il faut d'abord durer " Hemingway

[Guest guest]

, A friend who spoke at the CMS hearing pulled all his bills for chemo and chemo related meds/ER/transfusions, etc for the past 11 months and it came out to over the price of Provenge. He had it broken down by the item. I hate the money that goes into “me too†drugs. Just posted something on the VPCC Facebook page related to that issue that you might want to read. Kathy From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of EmersonSent: Friday, November 19, 2010 7:07 AMTo: ProstateCancerSupport Subject: Re: Provenge moves forward! Baby steps . Sure I'd like a cure too. I have a few less years under my belt than most of you and therefore have a few more unfulfilled dreams and wants to complete. Maybe Provenge gives me a few years, who knows? What I do know is this; if I were to receive it (it is very likely my next treatment) I am VERY confident I'll out live the 'average'. How do I know? - 'Statistics' told me when I was first diagnosed that I had 36 months to live. That was 58 months ago.Our friend 'Statistics' also told me this medicine would last x long and that one would last longer. Neither prediction was correct. If/when I take Provenge and it stops working I know there a other options out there. A cure? No, not yet. In all likelihood not in my short lifetime either. Provenge is getting beat up here and other places for the price. This is sure to come down. The first decline will come when Medicare announces their reimbursement rate and that will ripple through the insurance industry. Will it be cheap? Certainly not. I still haven't seen an accurate comaparison to a cycle of 6-8 Taxotere treatments? A fair comparison, not just the cost of Tax, but an all inclusive cost of tests, scans etc. On another but related note, where's the outrage over Amgen's announcement yesterday regarding Denosumab? The FDA approves the drug and in one of the news stories it specifically states that the cost is double that of Zometa with NO increased benefit! Sorry for the rant. I don't do this too often and I send this with the utmost respect for your opinions and everyone else's. The entire situation is terribly frustrating at times! davide  Ho Hum. I am sorry guys but all this Provenge twitter is just more about tinkering around the edges. After the expenditure of Billions (with a capital this is the best they can do? How about a cure? NASA put a man on the moon, but it seems our cancer research efforts could not get us on the crosstown bus. " Lord, what fools these mortals be! " Shakespeare, " A Midsummer Night's Dream " , Act 3 scene 2 Provenge moves forward!To: ProstateCancerSupport Date: Thursday, November 18, 2010, 6:47 PM I guess I must be the only one on this group who is not impressed by this Dendreon - Provenge " adventure " . Gaining four months survival at the end of life with Provenge, but still stuck on castration drugs, is not my idea of scientific or medical greatness. You could possibly get as long, maybe more by going on testosterone patches - and have a much happier time of it too !Now, if anyone is excited about Provenge being a money-spinner that is a different matter, and I can see why so many are putting / have put their names to the " Let's all get Provenge OK'd by the FDA " .There are other investment goodies coming up, like Alpharadin for instance. But if / when you do your homework you'll see there is no advantage over Metastron. Provenge, like Alpharadin and like Dutasteride a while ago, will generate a lot of froth and the kind of circuitous investment activity that got the whole investment world into trouble a couple of years ago. The reason: simply because there is no real inherent profit or true social value in this stuff. Compared to a real cure for prostate cancer, or a significant extension of life - years not a handful of months, these market goodies are for the punters, not the patients.This link gives an example of what I am talking about. http://www.nytimes.com/2010/11/18/health/18prostate.html?_r=2 & hpwThere is also a commentary on the Provenge - FDA issue showing just how close Dendreon have cut it. If I were to put my money on anything to do with Dendreon, I'd say they were chasing overheads and losses from 15 years of developing this essentially failed drug. 4 months ? Give us a break !Sam. -- Emersonwww.flhw.orgEvery 2.25 minutes a man is diagnosed with prostate cancer.Every 16.5 minutes a man dies from the disease.

[Guest guest]

Terry,I appreciate what you say below, however, there is also the flip side. Unless I am mistaken, the survival curve has a 'normal distribution' and is symmetric about the mean. See :-http://en.wikipedia.org/wiki/Normal_distribution

By comparing the survival curve for the placebo group and the trial group (same shape, different mean positions) there is a suggested shift to the right for the latter representing four months survival.Now, because an additional four month survival beyond the median will also be well within bounds of many men on placebo, what this means is that there is a great overlap between the groups:-

Some (a few) will enjoy more than four months, some less. This means there will also be men who do not benefit from the drug as much as men who do, and there will be other men who did not survive as long on the trial drug, as some men survived on the placebo! That is how close you are cutting it with a " four month median survival " , and that is what I find unimpressing.

Putting it another way: Clearly, there is not a 'cut-off' as some seem to think which implies that all men in the trial group enjoy this additional four months survival. As for my comments on testosterone patches for men with HRPC disease, yes I do have references. They are in a book. ISBN 9780954993511 I have taken the time to lift a couple of paragraphs. See below.

Sam there are many men who are unimpressed with Dendreon - Provenge and mostof them seem to fail to understand the difference between a median survivaland an overall survival. The four months 'improved survival' commonlyreferred to in media reports refer to the median times in the main study. Inother words half the men on Provenge lived four months longer than half themen who were not on Provenge. What they don't show, because it gets a bitcomplicated and doesn't fit into a 'sound bite' is that the 50% of the menon Provenge who survived beyond the median significantly outlasted 50% ofthe men in the control group and some are still alive today.

When you say <snip> You could possibly get as long, maybe more by going ontestosterone patches <snip> I say " As long as what? The median survivaltime? The end time? Do oyu have any references to support your view thattestosterone patches can enhance the survival of men with T4 aggressivedisease? Just interested to know if this is your opinion or a view backed by any evidence at all.

All the bestProstate men need enlightening, not frighteningTerry Herbert - diagnosed in 1996 and still going strongRead A Strange Place for unbiased information at-- Sam.

For your delectation and edification:-http://poetryfromtheprostrateyears.com/From page 120-1 of my book.

Over

fifty years ago the urologist Olaf Pearson observed androgen

supplementation would induce remission of painful symptoms of

advanced bone metastases in a number of patientsi.

To induce disease remission, Pearson used testosterone propionate

injection (50 mg daily) at twice the dose Huggins used to induce the

same prostate cancer in his patients. In

1967 Prout wrote of similar observations in the journal Cancerii.§

Being

so relatively long ago when most medical reports had an anecdotal and

subjective ring to them, the studies by Prout and Pearson might have

been explained away as wishful thinking. But what is described next

in controlled studies is remarkable.

In

2003, a phase 1 trial at Memorial Sloane Kettering Hospital in New

York (MSK) demonstrated that rapid androgen cycling for men following

surgery with a rising PSA does not produce radiographic or clinical

progressioniii.

In the following year at MSKiv

another study demonstrated normal male range serum androgen levels

obtained by using x3 daily standard Testoderm patches

or x3 Androgel

packets for men on medical castration therapy with a rising PSA was

feasible: Declines in PSA were achieved in some, stabilisation in

others, with no tumor

flare

(i.e. no radiographic response) in any. Two randomized phase 1

studies published in early 2009 tell us, after all these years, that

testosterone

is a feasible and well-tolerated therapy

for

men with early CRPCv'vi.

The treatment of early stage castration naïve diseasevii,

rather than therapy as a last ditch attempt to treat iatrogenic CRPC

is an area in much need of opening up.

In

the absence of much mainstream science taking up the torch in the

field of androgen therapy, it has been left to private practitioners

to anecdotally report on their work, in isolation and open to

criticism. The denial of therapeutic androgen may have been a

profitable approach for the pharmaceutical companies who were

bankrolling most prostate cancer research into supporting chemical

castration, but it was not good for evidence based science and it

certainly was not good for the prostate cancer patient.

§

Prout

describes the case of a terminal prostate cancer patient weighing

just 70 pounds, so weak he had to be carried to hospital. Following

androgen injection at levels higher than Huggins used, the patient

survived a year, gaining about twenty pounds in weight. If

in addition to androgen

supplementation,

had this patient the benefit of full scale estrogen

control

using aromatase inhibitors plus dietary and exercise

interventions

to reduce adipose tissue; and, management of androgenic production,

including their degradation enzymatic pathways, he may have survived

longer than one year. There are however as yet no adequate studies

to give androgen

therapy

a comprehensive fair trial.

i

Olaf H. Pearson.

Discussion of Dr. Huggins' Paper " Control of Cancers of Man by

Endocrinological Methods "

Cancer Research; 1956. pp 473-9.

http://cancerres.aacrjournals.org/cgi/reprint/17/5/473.pdf

ii

Prout GR Jr, Brewer WR. Response

of men with advanced prostatic carcinoma to exogenous administration

of testosterone. Cancer.1967

Nov;20(11):1871-8. PubMed:4168724

iii

L.T.

Nordquist, N. Sauter, M. , O. Smaletz, K. Konopelski, A.

Delacruz, G. Heller and H. I. Scher Hormonal

induction followed by rapid hormonal cycling for prostate cancer

(PC): the MEN's Cycle;

Memorial

Sloan Kettering Cancer Center, New York, NY 4609

Google:<ASCO 101825>

iv

M. J. , W. K. , S. Slovin, N. Sauter, C. Eicher, K.

Regan, T. Curley, A. Delacruz, V. Reuter, H. I. Scher; Memorial

Sloan-Kettering Cancer Center, New York, NY. Phase

I trial of exogenous testosterone (T) for the treatment of castrate

metastatic prostate cancer (PC).

Abstract No: 4560 Journal

of Clinical Oncology,

2004 ASCO Annual Meeting Proceedings (Post-Meeting Edition). Vol 22,

No 14S (July 15 Supplement), 2004: 456 Google: < ASCO

2004 4560 >

v

Szmulewitz R, Mohile S, Posadas E, Kunnavakkam R, Karrison T,

Manchen E, Stadler WM. A Randomized Phase 1 Study of

Testosterone Replacement for Patients with Low-Risk

Castration-Resistant Prostate Cancer. Eur

Urol. 2009 Feb 27. PubMed:19282098

vi

MJ, Huang D, WK, Slovin SF, son RD, Eicher C,

Delacruz A, Curley T, Schwartz LH, Scher HI. Phase

1 Trial of High-Dose Exogenous Testosterone in Patients with

Castration-Resistant Metastatic Prostate Cancer.

Eur Urol. 2009 Apr 3. PubMed:19375217

vii

Khera M, Grober ED, Najari B, Colen JS, Mohamed O, Lamb DJ,

Lipshultz LI. Testosterone

replacement therapy following radical prostatectomy.

J Sex Med. 2009 Apr;6(4):1165-70. PubMed:19207277

[Guest guest]

Very well said Alan. Kathy From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Alan MeyerSent: Thursday, November 18, 2010 5:29 PMTo: ProstateCancerSupport Subject: Re: Provenge moves forward! Georgia Sam wrote:> I guess I must be the only one on this group who is not> impressed by this Dendreon - Provenge " adventure " . Gaining four> months survival at the end of life with Provenge, but still> stuck on castration drugs, is not my idea of scientific or> medical greatness. You could possibly get as long, maybe more> by going on testosterone patches - and have a much happier time> of it too !Sam,I understand that point of view, and it makes some sense, but Iam impressed by Provenge for a number of reasons:1. As Terry says, some men will have a response that is better,and maybe even much better, than the average response.2. Provenge has only been tried on men who have failedconventional therapy, including ADT and chemotherapy. Thismay be too late to get the greatest benefit from the process.It may turn out that it will be dramatically more successfulif and when it is tried earlier.3. Provenge has few undesirable side effects.It appears to be easier to tolerate than chemo and may evenbe easier than ADT.4. The approach taken by Provenge is revolutionary.Dendreon is not the only company working on this approach andPCa is not the only cancer that might benefit from it.Immunotherapy for cancer is very new, relatively speaking.It has nothing in common with either hormone or chemotherapy. It is a completely different technique for treatingcancer.Provenge is just the first shot at immunotherapy for PCa,just as physical castration was the first shot at hormonetherapy.It may turn out that experience with Provenge will enableDendreon and other companies and research centers to developbetter immunotherapies for the future.5. Provenge may work better in combination with other therapies.The scientific community is learning, largely from pediatriccancers, that combining multiple powerful drugs withdifferent mechanisms of action sometimes completely curescancers that were thought to be incurable.Hormone therapy, chemotherapy and immunotherapy seem to allkill overlapping but different populations of tumor cells.Using all together, before the cancer has become resistant toany one of them, may get us closer to a cure. Maybe it couldbe a real cure for at least some patients. Maybe all of thedrugs we have, taken with just one or two more partial cures,will be the magic potion that starts to cure the incurables.> http://www.nytimes.com/2010/11/18/health/18prostate.html?_r=2 & hpwThat looks very promising. It's always possible that that newdrug, or some other new drug, will cure PCa and eliminate allother therapies. If that happens, great! But I don't want giveup all the helpful drugs now on the speculation that a cure isaround the corner. Maybe, if a breakthrough drug arrives,Provenge will have kept some people alive long enough thatthey'll live to walk around that corner.It may also be that the new drug works well, but isn't quite acure, but when taken with ADT, chemo, and immunotherapy all atonce, it really cures people (point 5 above.)One thing I've learned from reading biochemistry and molecularbiology is that cancer research is really, really hard. It makesrocket science look easy. A cancerous cell has many tens ofthousands of different molecules and molecular sequences, tens ofthousands of biochemical pathways. All of them existing at adeep submicroscopic level, hidden away from observation, insideliving tissues that, if you take them apart to see what's goingon, immediately die and halt all of the processes you're tryingto observe. And even if you learn everything about one of thecells, which might not be achieved for hundreds of years, itturns out that different cells in the same patient often havedifferent disease characteristics.It's easy for us to criticize the scientists for not coming upwith cures, but my hat is off to them for the great progress thatthey are making with a disease that, until the middle of the lastcentury, _nobody_ knew how to do _anything_ about.Alan