Dr. C. W. Myers – Leukine and Prostate Cancer In this lecture Dr. Myers discussed the literature results dealing with the use of Leukine (reg.) as HRPC treatment option. Leukine is one trade name for GM-CSF, granulocyte macrophage colony stimulating factor. It is also available as “Sagramostim”, another commercial brand. The literature identifies GM-CSF substances as active products that assist the immune system in dealing with biologic threats. (Ed. note: for a good review of experience with GM-CSF (alias leukine), the reader is referred to the web site On this site you will find writeups that deal with the published results of trials involving leukine or GM-CSF. It has been used by itself and in combination with other drugs in chemotherapy trials and in trials of non-chemo therapies. Dr. Myers discussed the case of one patient with a GS=10, PSA>150, LN=+, and a PSA doubling time of 10-15 days. This patient had been treated with IMRT and hormonal therapy. He became refractory to the hormonal tx in approx. 6 mos. He did not respond to second line hormonal tx. He was started on Taxotere and had an undetectable PSA by the fourth month. In April of 03 the chemo was stopped and he was administered 30 days of Leukine. In Nov. of 03, Dr. Myers reported, his PSA became detectable and a second course of Leukine was administered. His PSA again dropped to undetectable. He continued receiving the Leukine approx. every 4 mos. on a continuing basis. In April 04 hormonal therapy was stopped. By Spring of 05 he had a “normal” testosterone level and PSA < 0.05 (Ed. note: this level of PSA had to come from the ultrasensitive test procedure). Patient has been off chemo for >2 yrs and is reported to be in complete remission and is under Proscar maintenance therapy. Dr. Myers went on to review the results from combinations of Leukine with Thalidomide, ketoconazole, and some other compounds. For full details the reader should go to the original Small paper from which Dr. Myers was gathering these data. The actual reference is: Small, E., et. al., Cin. Ca. Res. 1999, pp1738-1744. He completed his lecture by discussing how vaccine therapy works to educate the immune system to identify “foreign” cancer cells and to attack them with its own defense mechanisms, part of which employs GM-CSF. Dr. Myers concluded that the major advantage of Leukine is its availability today, in contrast to the several vaccines in various stages of development. Howard Scher, MD – Chemotherapy Combinations That Work Dr. Scher was a late substitute for Dr. Christopher Logothetis of MD Anderson in Houston, Texas. Dr. Scher is the Chief of Genitourinary Oncology Service at Memorial Sloan Kettering in NY. He is active in studying chemotherapy regiments for hormone refractory prostate cancer. Dr. Scher’s delivery was extremely rapid and the rate at which he changed the slides of his Powerpoint presentation made it difficult to obtain good notes. Interested readers are referred to his publications that can be obtained in at least abstract form from by entering “Scher H” in the author’s search field. However, his major take-home conclusion was that Taxotere with or without Estramustine has shown significant improvement in chemo treatments for PCa. This is from the work of Dr. Petrylak at Columbia Presbyterian who is the lead author of the most recent series of publications dealing with Taxotere based chemo regimens. These trial results showed overall survival benefits of some 2+ months as compared to the “standard of care” chemo therapy of methotrexate and prednisone. In the real world of uncontrolled hospital or office chemo administration of these chemo regimens, it remains to be seen whether the small advantage reported in the clinical trials will be maintained beyond such controlled experimental trials. Dr. Scher also discussed possible gains to be had by administering chemo drugs pre-operatively and immediately post operatively. He recommended measuring PSA doubling time and adding chemotherapy early in the cycle. Other combinations mentioned by him included taxotere plus vitamin D3, Atrasentan, Thalidomide, Gleevec, Exisulind, etc. (Ed Note: It appeared to the writer that the whole arsenal of possible chemo drugs that might be used was listed by Dr. Scher. Data on the effectiveness of these chemo regimens in treating PCa is not extensive and data on the possible combinations yet to be tried is still more scarce. Empiricism reigns supreme when it comes to PCa and chemotherapy). Dr. Sher referred to a new class of products called Ansamycins with which the writer is not yet familiar. He discussed the need to change endpoints in certain kinds of trials because PSA changes are not totally indicative of efficacy. (Ed.Note: The world of chemotherapy clinical trials is endless. It becomes a major source of funding for those laboratories that are staffed to conduct the work. Reputations are built on results from such trials. The Drug Industry cannot be relied upon to publish results from trials that are negative. Congress is considering legislation to require that all clinical trial results be published. It remains to be seen whether such legislation will pass. The “Clinical Trials Industry” is huge and has a large following with vested interest. Trials are supposed to be based upon solid evidence of efficacy. That this is not always the case is supported by the large number of chemo drugs whose overall success rates can be best described as marginal. Taking into account quality of life issues chemotherapy has a long way to go. Given our slow advances in “curing” cancer one has to wonder if the billions spent in developing these drugs have been well spent.) NPC Program Review, 6/05 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.