Provenge is the brand name for sipuleucel-T, an autologous cellular immunotherapy. You may think of vaccines as preventive, but this is a therapeutic vaccine.
Provenge is used to treat late-stage prostate cancer that no longer responds to hormone therapy (metastatic castrate resistant).
Provenge uses your own blood. The vaccine stimulates your immune system into recognizing and destroying prostate cancer cells.
It’s not recommended for everyone with prostate cancer. Continue reading to learn more about this therapy.
How effective is it for the treatment of
Provenge was approved for treatment of metastatic hormone-resistant prostate cancer in 2010. It’s intended for men who are having no symptoms or minimal symptoms. The vaccine encourages your immune system to seek out and attack prostate cancer cells.
It’s not a cure for prostate cancer, and is unlikely to stop cancer from growing. But Provenge has been shown to lengthen life in people with late-stage prostate cancer by an average of four months, with minimal side effects.
What are the possible side effects?
One advantage of Provenge is that side effects are generally less severe than those associated with chemotherapy or hormone therapy. Side effects usually start during the infusion itself, but clear up within a few days. Some possible side effects include:
- back and joint pain
Provenge is generally considered safe for men with advanced prostate cancer. The product label doesn’t list any known interactions with foods or other medications. You should still review all your over-the-counter and prescription medications with your doctor before starting treatment.
High blood pressure and difficulty breathing are less common side effects. Report breathing problems and other serious symptoms to your doctor right away.
What happens during the treatment?
There are two phases to treatment with Provenge:
- Create the vaccine. This involves removing white blood cells from your body.
- Administer the vaccine. Each procedure will be repeated three times.
Creating the vaccine
To create the vaccine, you’ll need to go to a cell collection center or hospital to have white blood cells removed from your blood. This process is known as leukapheresis. This will be done three days before you’re due to have the vaccine. The procedure takes a few hours during which you’ll be hooked up to a machine.
The white blood cells will be sent to a laboratory or special manufacturing center. Prostatic acid phosphatase (PAP), a protein found in prostate cancer cells, will grow with the white blood cells. PAP helps your immune cells to recognize prostate cancer cells. Once the vaccine is ready, it will be returned to the hospital or infusion center.
Administering the vaccine
Your doctor may give you acetaminophen (Tylenol) and an antihistamine about half an hour before administering the vaccine. This is to reduce the chances of side effects such as fever and chills.
The vaccine is administered by intravenous (IV) infusion in a medical facility. The process takes about an hour. If you don’t have a suitable vein, the treatment can be administered through a central venous catheter. You’ll be monitored for another half hour or so before you’re allowed to go home.
You will receive three doses of the vaccine at two-week intervals. You’ll know what to expect because the schedule is set in advance. This is important because if you miss an infusion the Provenge may no longer be viable. In that case, you might have to repeat the leukapheresis to make a new vaccine.
Are there other immunotherapies for prostate
Provenge was the first therapeutic vaccine approved to treat advanced prostate cancer. To date, it’s the only one.
There are a few experimental immunotherapies for prostate cancer currently in clinical trials. These include:
- rilimogene galvacirepvac (Prostvac), a therapeutic vaccine
- aglatimagene besadenovec (ProstAtak), an oncolytic virus therapy
- checkpoint inhibitors
- adoptive cell therapy
- adjuvant immunotherapies
- monoclonal antibodies
Research into treatment for advanced prostate cancer is ongoing. New clinical trial opportunities may arise at any time.
Talking to your doctor
Your doctor will monitor the prostate-specific antigen (PSA) levels in your blood. If your PSA level is going down, it usually means treatment is working. A rise in PSA levels may mean treatment isn’t effective. It’s not always easy to interpret these results. The results can help your doctor make recommendations before and during treatment.
Ask your doctor if you’re a good candidate for Provenge and about the potential benefits and risks. Also discuss what other treatments are still possible and if you can have more than one treatment at a time.
Another consideration is the expense. One cost analysis put the price of Provenge treatment at $93,000, or $22,683 per month of added median survival. Your doctor’s office can help determine how much of this cost would be covered by your health insurance, and other financial arrangements.
What’s the outlook?
The goal of advanced prostate cancer therapy is to maintain the best quality of life for as long as possible. Provenge is one way to work toward that goal.
Clinical trials can give you access to experimental treatments that aren’t approved for advanced prostate cancer. They usually have strict criteria. If you’re interested, your doctor can provide more information about clinical trials and whether you might meet the eligibility requirements.
At some point, you may decide that you don’t want to treat the cancer anymore. Talk to your doctor about all your choices before making this decision. Even if you don’t want to treat the cancer, you can still be treated for pain and other symptoms.