Prostate Vaccine - You gonna get one???

[aboveliquidice]

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Approved Thursday... Note that only 2000 patients can receive it this year, and cost is defintely prohibitive (93k). This cost is due to the need to manufacture it INDIVIDUALLY for each patient. This is a pretty crazy proof of concept. It doesn't cure / prevent prostate cancer - but it does prolong life.

Source: USATODAY - LINK

Discuss:

 

[297point1]

vaccine (vak-seen)
–noun
1. any preparation used as a preventive inoculation to confer immunity against a specific disease, usually employing an innocuous form of the disease agent, as killed or weakened bacteria or viruses, to stimulate antibody production.
2. the virus of cowpox, used in vaccination, obtained from pox vesicles of a cow or person.
3. a software program that helps to protect against computer viruses, as by detecting them and warning the user.

As the OP notes, this product is not a vaccine, it only prolongs survival. So WHY is it being authorized to label itself a VACCINE?

If this can be called a vaccine, what is preventing the manufacturers of TPA from calling their product a 'stroke vaccine', the makers of Taxol could market it as a 'breast cancer vaccine', and for simvastatin- a 'second MI vaccine'.

Viagra could even be marketed as a 'disappointing evening vaccine'.

This is ridiculous...I'll pass, thank you very much.

 

[Neuron14]

This is from the National Cancer Institute website.

There are two broad types of cancer vaccines:

1) Preventive (or prophylactic) vaccines, which are intended to prevent cancer from developing in healthy people; and

2) Treatment (or therapeutic) vaccines, which are intended to treat already existing cancers by strengthening the body's natural defenses against cancer.

 

[297point1]

That's a stretch IMO, but at least now I see how they can call it a vaccine.

Thanks for the insight!

 

[joetrisman]

vaccine (vak-seen)
–noun
1. any preparation used as a preventive inoculation to confer immunity against a specific disease, usually employing an innocuous form of the disease agent, as killed or weakened bacteria or viruses, to stimulate antibody production.
2. the virus of cowpox, used in vaccination, obtained from pox vesicles of a cow or person.
3. a software program that helps to protect against computer viruses, as by detecting them and warning the user.

As the OP notes, this product is not a vaccine, it only prolongs survival. So WHY is it being authorized to label itself a VACCINE?

If this can be called a vaccine, what is preventing the manufacturers of TPA from calling their product a 'stroke vaccine', the makers of Taxol could market it as a 'breast cancer vaccine', and for simvastatin- a 'second MI vaccine'.

Viagra could even be marketed as a 'disappointing evening vaccine'.

This is ridiculous...I'll pass, thank you very much.

I only glanced at the news article in passing and haven't taken them time to look into any papers on it...

...But I imagine that they extract some sort of unique surface marker to your cancer, add an adjuvant, and shoot you back up to induce an adaptive immune response to those cells. Pretty simple in theory, not really sure why it wouldn't be more effective at possibly curing the disease, but then again, I'm no expert on cancer.

 

[MindOverMatter]

cost is defintely prohibitive (93k)

 

[Quiksilver]

Approved Thursday... Note that only 2000 patients can receive it this year, and cost is defintely prohibitive (93k). This cost is due to the need to manufacture it INDIVIDUALLY for each patient. This is a pretty crazy proof of concept. It doesn't cure / prevent prostate cancer - but it does prolong life.

Source: USATODAY - LINK

Discuss:

93K to live an extra 4 months when surveillance and preventative medicine are much cheaper and much more effective in the first place. When caught early enough, prostate cancer can be managed like a chronic disease but this requires people to be as proactive about their health as they are with their paychecks.

It is nice if it can be a prototype that can be used to fight other cancers and perhaps be more effective.

 

[Neuron14]

I only glanced at the news article in passing and haven't taken them time to look into any papers on it...

...But I imagine that they extract some sort of unique surface marker to your cancer, add an adjuvant, and shoot you back up to induce an adaptive immune response to those cells. Pretty simple in theory, not really sure why it wouldn't be more effective at possibly curing the disease, but then again, I'm no expert on cancer.

👍

Yea, that's basically how this cancer vaccine works - I'm a research fellow in a cancer immunology lab that develops cancer vaccines and other forms of immunotherapy.

There are two main goals in cancer vaccine development:

1) Find a tumor-specific target (or relatively tumor-specific)
2) Develop vaccine against target that creates a powerful immune response (This is the challenge)

Therapeutic cancer vaccines by themselves aren't very effective because they generate pretty weak immune responses. However, when they're used in combination with other therapies (usually prior to them) they are very effective at improving survival. The earlier you give them, the more survival is improved. Other forms of immunotherapy, such as TIL adoptive cell transfer, are more effective at shrinking the size of the tumor, but patients can have pretty severe autoimmune reactions.

 

[litetigre]

vaccine (vak-seen)
–noun
1. any preparation used as a preventive inoculation to confer immunity against a specific disease, usually employing an innocuous form of the disease agent, as killed or weakened bacteria or viruses, to stimulate antibody production.
2. the virus of cowpox, used in vaccination, obtained from pox vesicles of a cow or person.
3. a software program that helps to protect against computer viruses, as by detecting them and warning the user.

As the OP notes, this product is not a vaccine, it only prolongs survival. So WHY is it being authorized to label itself a VACCINE?

If this can be called a vaccine, what is preventing the manufacturers of TPA from calling their product a 'stroke vaccine', the makers of Taxol could market it as a 'breast cancer vaccine', and for simvastatin- a 'second MI vaccine'.

Viagra could even be marketed as a 'disappointing evening vaccine'.

This is ridiculous...I'll pass, thank you very much.

It's called vaccine because it inoculates your immune system with antigen. Your body fight the tumor by develop immunity against it. It is the concept, just like flu, chickenpox, herpes vaccines etc.
If you recalled, even if you are vaccinated with flu vaccine, there is still a chance to develop flu if you acquire a strain that your immune system were not exposed to.
So yes, this drug is a vaccine. So sad that it call only prolong 4 months. But if you have a dying love ones, you'll do all you can to keep them alive, even just 1 day or 1 hour.

 

[297point1]

I'm still having trouble wrapping my mind around the idea that you can give a 'vaccine' for a disease you've already got. You aren't going to give this 'vaccine' to people who don't have prostate cancer (at least not yet...)

Why not just call it a treatment?

Oh well, if the NCI wants to call it a vaccine, I'd better get comfortable with the lingo; they've got a little more pull than I do 🙂

 

[aboveliquidice]

93K to live an extra 4 months when surveillance and preventative medicine are much cheaper and much more effective in the first place. When caught early enough, prostate cancer can be managed like a chronic disease but this requires people to be as proactive about their health as they are with their paychecks.

It is nice if it can be a prototype that can be used to fight other cancers and perhaps be more effective.

True - but I believe this vaccine is directed at those not responding to other therapies ( I assume that includes surgical and hormone).

 

[litetigre]

I'm still having trouble wrapping my mind around the idea that you can give a 'vaccine' for a disease you've already got. You aren't going to give this 'vaccine' to people who don't have prostate cancer (at least not yet...)

Why not just call it a treatment?

Oh well, if the NCI wants to call it a vaccine, I'd better get comfortable with the lingo; they've got a little more pull than I do 🙂

Agree. It might cause ordinary people to mistake that it will prevent them from having prostate cancer. Maybe we should separate vaccination and immunization and make it clear with the public. Those terms should not be used interchangeably.
For the vaccine after disease. I think of rabies, if you were to be bitten by an infected dog, you can still have rabie vaccine that saves your life. So anything is possible.

 

[Quiksilver]

True - but I believe this vaccine is directed at those not responding to other therapies ( I assume that includes surgical and hormone).

From the article it seems that it is used in palliative/Stg IV disease. Most patients won't present here unless they are very old and for some reason were not monitored prior to finding the disease here. Prostate CA is a slow growing tumor and there should be not a reason it goes this far as long as guidelines are followed. My point is surveillance is the best practice in prostate cancer. Could save 93,000 dollars in the long run. Very few patients should need this.

 

[diethylamide]

I might be wrong but I was under the impression that most of the trials with this vaccine and other similar treatments have only been done on patients who have already had other multiple treatments thereby already compromising their immune system. It will be interesting to see how a healthy(er) immune system fights the cancer in conjunction with this vaccine. Again, I could be wrong about this, I looked at this stuff about a year ago it's been an ongoing story with Dendreon for a while.

 

[Praziquantel86]

I might be wrong but I was under the impression that most of the trials with this vaccine and other similar treatments have only been done on patients who have already had other multiple treatments thereby already compromising their immune system. It will be interesting to see how a healthy(er) immune system fights the cancer in conjunction with this vaccine. Again, I could be wrong about this, I looked at this stuff about a year ago it's been an ongoing story with Dendreon for a while.

That's very true...I haven't read any of the studies yet, but does anyone know if there were cutoffs for neutrophil counts to be eligible for the study?

 

[Sparda29]

 

[Priapism321]

That's very true...I haven't read any of the studies yet, but does anyone know if there were cutoffs for neutrophil counts to be eligible for the study?

WBC 2,000 and ANC 1,000 for the first phase III.

No patients with liver, lung, or brain metastases included.

 

[Aznfarmerboi]

From the article it seems that it is used in palliative/Stg IV disease. Most patients won't present here unless they are very old and for some reason were not monitored prior to finding the disease here. Prostate CA is a slow growing tumor and there should be not a reason it goes this far as long as guidelines are followed. My point is surveillance is the best practice in prostate cancer. Could save 93,000 dollars in the long run. Very few patients should need this.

The significance of this isnt so much that it can extend a patients life by 4 months (out of 22 months which is significant to anybody with cancer), but that it puts another option on the table leading to future research. This allows us to learn more about the disease state itself, investigate synergy of combination drugs (4+4 = 12 months???), etc. For some cancer patients, 4 months might mean the difference between life and death if there is another treatment option coming out (but they dont have access to it). I am not an oncologist or oncology pharmacist but when I was school, a good portion of what I studied (and largely forgot) were newer drugs or drugs coming out.

 

[medicalCPA]

The vaccine was tested in people with advanced disease. I wonder whether this therapy would be more useful in patients in the earlier stages of prostate cancer.


*Evidence that I have stocks too much on the brain*: Anyone notice how much Dendreon's stock price has zoomed upward?

 

[litetigre]

I like the idea of stimulating your own immune system. It opens a new path for treatment and who knows a new field for pharmacy.

 

[Priapism321]

This drug is not revolutionary beyond its concept (everyone is excited about cancer vaccines, but the science is not keeping up with the enthusiasm). $100,000 for 4 months against NOTHING, this is severely lackluster. There are trials for the same group of patients showing similar benefits (off the top of my head, abiraterone).

 

[Quiksilver]

The significance of this isnt so much that it can extend a patients life by 4 months (out of 22 months which is significant to anybody with cancer), but that it puts another option on the table leading to future research. This allows us to learn more about the disease state itself, investigate synergy of combination drugs (4+4 = 12 months???), etc. For some cancer patients, 4 months might mean the difference between life and death if there is another treatment option coming out (but they dont have access to it). I am not an oncologist or oncology pharmacist but when I was school, a good portion of what I studied (and largely forgot) were newer drugs or drugs coming out.

93K to live an extra 4 months when surveillance and preventative medicine are much cheaper and much more effective in the first place. When caught early enough, prostate cancer can be managed like a chronic disease but this requires people to be as proactive about their health as they are with their paychecks.

It is nice if it can be a prototype that can be used to fight other cancers and perhaps be more effective.

Exactly what I was getting at. I know what it is, its a potential gateway. The thing is, not many patients are going to drop 90K on a therapy. Life is sacred but unless you have the money it will not benefit you. And I don't think you are going to find hospitals or insurances that are going to eat that cost for an extra 4 months.

I do think that this is a potential lead to something that may be useful. How useful we won't know for several years. the word cure is a difficult word to use in cancer since it is so hard to obtain and is obtainable if it is either caught early or if you have a specific type that can be cured. In these patients in this study that are at the end, it won't matter for them.

CA treatment has come a long way though and as you said there are a lot of promising treatments that are new and upcoming from MAbs and TKIs

 

[aboveliquidice]

Exactly what I was getting at. I know what it is, its a potential gateway. The thing is, not many patients are going to drop 90K on a therapy. Life is sacred but unless you have the money it will not benefit you. And I don't think you are going to find hospitals or insurances that are going to eat that cost for an extra 4 months.

I do think that this is a potential lead to something that may be useful. How useful we won't know for several years. the word cure is a difficult word to use in cancer since it is so hard to obtain and is obtainable if it is either caught early or if you have a specific type that can be cured. In these patients in this study that are at the end, it won't matter for them.

CA treatment has come a long way though and as you said there are a lot of promising treatments that are new and upcoming from MAbs and TKIs

Proof of concept... This is a new tool in the bag that can be utilized. In a world where most of the low hanging fruit have been picked, these discoveries and subsequent implementations will become more and more important.

Exciting stuff.

 

[Quiksilver]

This drug is not revolutionary beyond its concept (everyone is excited about cancer vaccines, but the science is not keeping up with the enthusiasm). $100,000 for 4 months against NOTHING, this is severely lackluster. There are trials for the same group of patients showing similar benefits (off the top of my head, abiraterone).

Abiraterone lowers PSA like crazy. Looks very promising and much cheaper. I've seen it in action. Pretty cool stuff.

Proof of concept... This is a new tool in the bag that can be utilized. In a world where most of the low hanging fruit have been picked, these discoveries and subsequent implementations will become more and more important.

Exciting stuff.

Again, if people can afford it. In pharmacy school we see all these great drugs that do amazing things but at this cost and until there is some evidence of really significant improvements in patient's conditions, this drug won't be very useful clinically. Can this model be used for other cancers? we will see. It is certainly worth looking into. Currently, I see this as a gateway until more evidence is found.