My experience with a phase III trial of Provenge has been covered in
earlier pages here. This is intended to document my status after
leaving the clinical trial.
Briefly: A participant has his immature dendritic cells harvested and
the vaccine prepared using them infused two days later on weeks one,
three, and five. That completes the treatment phase. Follow-up is by
bone scan and/or CT scan about every 8 weeks, depending upon where
metastases were found on baseline scans.
After about a year on the program, the blind was broken, and I
discovered I had received the placebo, and then enrolled on the
secondary trial where I received the real vaccine prepared from my cells
that had been frozen and saved. My first bone scan (no CT scans have
ever shown soft tissue involvement) following this follow-on
(cross-over) treatment phase was on 4/30/03.
On 5/28/03 at a follow up appointment with the trial site's urologist
to discuss the bone scan, I asked if he had ever seen anyone on the
trial in my situation (i.e., progression after receiving the actual
vaccine in a follow-up trial) who then achieves regression or even
stability. He answered that he had not. In effect, I was off the trial.
I had a scheduled appointment with my medical oncologist on June 19th
at which time we discussed options for my next treatment. (Previous
treatments were RRP 5/28/92, hormone therapy '93-'96, 2nd line hormone
treatments - aminoglutethimide + cortef 5/97-4/00, and experiments with
PC-SPES, GCP/AHCC, and the rife-bare frequency generator. During all
this time and to the present I continued with Lupron.)
By the time I had base line tests for the Provenge trial, my PSA had
risen to 44.1. Coming out of the follow-up trial, it had risen to 309.1.
I suggested to my oncologist that we might re-try the aminoglutethimide
+ cortef, which had worked for me in the past. Before making any
decisions, she wanted to start me on Zometa, which we did. First
infusion was on 6/24/03. Because of an intervening vacation, 2nd Zometa
infusion was on 8/12/03, at which time the PSA had dropped to 190.2.
At that time I re-started the aminoglutethimide + cortef, which has
continued from then on, along with 3-mo Lupron shots and monthly Zometa
infusions.
My PSA has bounced around quite a bit over this time:
| Date |
PSA |
|
9/15/03 |
243.2 |
|
10/13/03 |
339.8 |
|
11/10/03 |
316.3 |
|
12/11/03 |
290.6 |
| 1/8/04 |
453.7 |
| 2/23/04 |
302.9 |
| 4/7/04 |
393.5 |
|
5/10/04 |
355.5 |
| 6/7/04 |
268.3 |
Despite these high numbers, I still feel physically OK. I do have
metastases, but cannot identify any pain or discomfort caused by them.
The only pain medication I take is Celebrex, and because of a goof-up I
was without it for about 3 days. I did experience some minor pain during
this time, but it went away as soon as I was able to take the Celebrex
again, making me think it was arthritic in origin rather than from PCa.
The impression reported on my latest bone scan in January was of
"fairly stable metastatic disease."
So, something's going on, but my QOL is pretty darn good, all things
considered. I'm able to exercise regularly with tennis and table tennis,
my appetite is (too) good, and my GP said today that all my vital signs
are excellent.
Over the years I have avoided radiation, and I'm hoping to postpone
chemo for as long as possible. After all, maybe one of the trials on
immune system, gene, anti-angiogenesis, etc. therapies will prove out
and provide, if not a cure, at least positive control with few or no
side effects. (BTW, I had zero side effects from the Provenge vaccine)
/jack
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Jack M. Beaven
Dayton, Ohio 12 year PCa
survivor
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