Ralph A. Highshaw, M.D.

Provenge is now approved by the FDA for use in patients with metastatic, hormone refractory prostate cancer. These are patients who do not respond to androgen deprivation therapy. Androgen deprivation therapy involves lowering testosterone levels in the body to below castration levels. This is done because prostate cancer cells feed by testosterone. In a clinical trial of 512 patients across multiple institutions, Provenge was shown to improve the overall survival of prostate cancer patients by 4.1 months.

Provenge, which is manufactured by the Dendreon Corp., works by stimulating the patients own immune system to fight and kill prostate cancer cells. The white blood cells, which protect one from non-self influences, are removed from the body and sensitized to a prostate cancer protein. These white blood cells are placed back into the patient, which seek-out prostate cancer cells to destroy.

Some of the side effects from taking Provenge include chills, fatigue, fever, back/joint pain, nausea, and headaches. These are considered mild to moderate reactions and account for the majority of the adverse reactions. The more severe reactions to this medication reported are cerebrovascular events such as strokes, which occurred in 3.5% of patients in the study.

Dr. Soloway, professor and chair of urology at the University of Miami Miller School of Medicine, has stated that “There are problems with Provenge”.  “One is that it’s very cumbersome, because patients have to provide their white cells, and I think that’s on a regular basis. And two, it’s likely to be very expensive.”  I would tend to agree. Having said that, Provenge does provide patients with an alternative treatment for prostate cancer, and that is promising.

For more information about  Provenge contact Dr. Highshaw at (714) 751-0100

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