Provenge-4

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Update of May 2003, after the April 2003 Bone Scan:

Jack writes: Here's my (simplified/condensed) history on Dendreon's Provenge trial:

Date	Status
12/27/01	Baseline. Bone scan shows uptakes on left scapula (1st noted 1/93), and T7 (never noted before), plus two other areas later deemed to be degenerative rather than metastatic. CT Scan indicates no soft tissue involvement.
Jan/Feb '02	Harvest dendritic cells; infusion of vaccine (or placebo)
2/28/02	Bone scan essentially the same as baseline.
5/15/02	Bone scan essentially the same as baseline.
7/8/02	Bone scan as above, but with new area on sternum felt to be metastatic.
9/4/02	Bone scan as 7/8, but with new areas noted on left 9th rib and left femur.
11/25/02	Bone scan as 9/4, but no mention of sternum or left femur, and new area on right scapula.
2/10/03	Only 3 areas noted on bone scan: left scapula, T7, and new area on 4th posterior right rib.
2/11/03	Dendreon breaks the blind and I find that I had received placebo.
3/5-4/2/03	I participate in a follow-up trial with infusions of actual vaccine made up using my dendritic cells that had been originally harvested, frozen, and saved for the purpose.
4/30/03	Bone scan shows uptakes on left scapula, T7, right scapula, 4th posterior right rib, plus new areas on right 9th rib and at T3. Impression: "Slight progression of bony metastatic disease."

Needless to say, I'm disappointed in this first follow-up bone scan -- but maybe there hasn't yet been enough time for the vaccine to have a positive impact.

On 5/28/03 at a follow up appointment with the trial site's urologist to discuss the 4/30 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.

I have a scheduled appointment with my medical oncologist on June 19th at which time we'll discuss options for my next treatment.

My best,

/jack
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Jack M. Beaven MahlonBeav@juno.com
Dayton, Ohio 11 year PCa survivor

Note: A recent presentation at ASCO 2003 indicates this vaccine is most effective for Gleason sums of ≤ 7. In 1992, Jack's Gleason sum was a 6 (3+3).

E. J. Small, B. Rini, C. Higano, C. Redfern, J. Nemunaitis, F. Valone, J. Kylstra, P. F. Schellhammer, A randomized, placebo-controlled phase III trial of APC8015 in patients with androgen-independent prostate cancer (AiPCa)), ASCO 2003, Abstract # 1534.

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