A first-of-a-kind prostate cancer treatment that uses the
body's immune system to fight the disease has received US
government approval, offering an important alternative
to more intensive treatments like chemotherapy.
Dendreon Corp.'s Provenge vaccine trains the immune system to
fight tumors. It's called a "vaccine" even though it treats
disease rather than prevents it.
Doctors have been trying to develop such a therapy for
decades, and Provenge is the first to win approval from the
Food and Drug Administration.
"The big news here is that this is the first immunotherapy to
win approval, and I suspect within five to ten years
immunotherapies will be a big part of cancer therapy in
general," said Dr. Phil Kantoff, an oncologist at the
Dana-Farber Cancer Institute who helped run the studies of
Provenge.
Experimental vaccines to treat other cancers - including the
deadly skin disease melanoma and an often fatal childhood
tumor called neuroblastoma - are already in late-stage
development.
Currently doctors treat cancer by surgically removing tumors,
attacking them with chemotherapy drugs or blasting them with
radiation. Provenge offers an important fourth approach by
directing the body's natural defense mechanisms against the
disease.
The drug is intended to treat prostate cancer that has spread
elsewhere in the body and is not responding to hormone
therapy.
Medical specialists hailed the approval as an important
milestone, but stressed it will serve as an addition to
current practice, not a replacement.
"This is just one step in a new pathway for treating
patients," said Dr. Simon Hall, chairman of urology at Mt.
Sinai Hospital "We have to make them realize this isn't a
cure, it's very variable."
Company studies showed that taking Provenge added four months
to the lives of men with advanced prostate cancer.
That may not sound like a lot, but it is longer than the
three months afforded by Taxotere, the only chemotherapy
approved for men in this situation. Doctors hope for even
greater benefit if they give the drug earlier in the course
of the disease.
Dendreon would give no cost estimate for Provenge, but
analyst estimates range from between $US60,000 ($NZ84,019) to
$US100,000.
The approval marks a remarkable turnaround for Seattle-based
Dendreon, whose shares plummeted three years ago when the FDA
delayed a decision on the therapy, asking for more proof of
safety and effectiveness. That delay came despite an expert
panel's recommendation for approval.
Dendreon shares jumped 19 percent to new highs ahead of the
news, rising to an all-time high of $US47.32. Trading of the
stock was halted, 35 minutes before the FDA announced its
decision. At the time, Dendreon shares were up $US5.88, or
14.8 percent, at $US45.50.
The company does not have any products on the market.
Analysts expect the product to reach blockbuster sales status
- over $US1 billion - by 2016, as the company expands
production capacity.
Each regimen of Provenge must to tailored to the immune
system of the patient using a time-consuming formulation
process.
Doctors collect special blood cells from each patient that
help the immune system recognize cancer as a threat. The
cells are mixed with a protein found on most prostate cancer
cells and another substance to rev up the immune system. The
resulting "vaccine" is given back to the patient as three
infusions two weeks apart.
Initially, Dendreon will identify Provenge patients through
the medical centers that helped test the drug. But
researchers have been told the company will only be able to
provide vaccines for a few patients at each site per month.
"There are going to be a lot of patients that want it and
there will be limited resources as they are getting this up
and running," said Dr. Deborah Bradley of Duke University
School of Medicine
About 192,000 new cases of prostate cancer were diagnosed in
2009, and 27,000 men died of the disease, according to the
FDA. Prostate cancer most often affects older men.
Side effects of Provenge are relatively mild, such as chills,
fatigue, fever, and headache. By comparison, side effects of
chemotherapy typically include hair loss, nausea, anemia and
diarrhea.
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