User talk:Ocyan/Sipuleucel-T

Ocyan-- Might I suggest a couple of additional sections? Shubinator has suggested along the line of my references to Provenge as a "breakthrough" (although that word is generally avoided as a "peacock" word) that we could include a section about how and why the treatment is unique--leaving it to the reader to draw their own conclusions as to the breakthrough nature of the results. I would suggest this include cited references to articles that pointed out that researchers have been trying for decades to train the immune system to recognize cancer as foreign and to attack it--how one of the insidious features of cancer is its ability to "hide" from the immune system--and that this is a first success in that particular fight. An additional aspect of the "breakthrough" section should also perhaps be that there is the additional benefit in this approach of far fewer side effects: most current strategies against cancer involve getting around the "hiding" feature of cancer by using poisons that target a particular feature of cancer, namely that the cells divide very quickly, and so any agent that attacks fast dividing cells is going to attack cancer cells. The downside of this strategy yields the well known side effects of traditional chemotherapy: hair loss, damage to fast dividing gut cells causing nausea, etc. Another very strong benefit of the "using the immune system" strategy is that it is much more "natural" and finely targeted to attack only the target antigen--and thus there are far fewer side effects and they are the traditional immune system ones of fever, chills, body aches... This section could also compare the side effects profile of Provenge with that of Taxotere--the only other approved treatment for this indication.

I also thought we might have a section on prospects for the future in which we could provide information about why this advance in treatment harnessing the immune system might portend greater advances against cancer in the future. This would entail explaining how and why getting approval for a cancer treatment must of necessity involve trials in late stage disease--since the only current "gold standard" endpoint is survival and the studies need to be over before patent protection for treatments run out and financing for the biotech runs out. And that since the "harnessing the immune system" strategy has succeeded in producing a survival advantage even in these very sick populations, researchers believe that when these types of treatments are used in patients with healthier immune systems the results will logically be even better. I know you are aware of Dr. Anna Ferrari's statement at one of Dendreon's analyst days that it was her hope that Provenge would prove to be a cure in men with earlier stage disease. And in fact there are ongoing studies which could provide the data necessary for Provenge to be expanded into earlier stage disease when combined with the clinical experience now being gained with the marketing of Provenge to a wide population.

Of course, as Shubinator has reminded us, all of this must come from cited secondary sources and allow the reader to come to his own conclusions about their significance. What do yo think? Shubinator--do you care to weigh in? SaulK (talk) 13:07, 27 August 2010 (UTC)[reply]

Saul - I am concerned that these sections will require a fair amount of research to get together the right references. I have heard many nice comments about the side effects of Provenge and how the treatment could be used in combinations with other existing or experimental treatments. But those comments were not in publications that could be cited. Simply stating them would violate the spirit of an encyclopedia.

Since the current page has too many flaws that it would be misleading to people searching for information on Provenge today, if everyone is ok with the current draft, we should publish it first. Then, we can look into further revisions to add opinions among the experts in the field about the future of active immunotherapy when proper citations are identified. Ocyan (talk) 14:16, 27 August 2010 (UTC)[reply]

I agree with your (SaulK's) first paragraph. You could put it in the "Mechanism" section instead of creating a new one.

With future prospects you need to be careful since we avoid speculation (see WP:CRYSTALBALL). You can add content saying "<Researcher> is studying the mechanism of Sipuleucel-T to engineer more effective cancer drugs^[citation]" or "There are ongoing studies for <>^[citation]".

As Ocyan says though, this might require a fair bit of digging.

Shubinator (talk) 14:40, 27 August 2010 (UTC)[reply]

I'm fine with doing the digging for sources on the future prospects, and I agree the draft Ocyan has created here is a vast improvement on the current entry. Let's publish it and then continue to work on supplements. SaulK (talk) 15:02, 27 August 2010 (UTC)[reply]

I added comments from popular press on Provenge after approval as Shubinator suggested. I also added a note that the National Cancer Network added Provenge to their compendium with the highest recommendation. This should take care of Saul's first comment. Ocyan (talk) 15:56, 27 August 2010 (UTC)[reply]

I'm uncomfortable with the "breakthrough" and "revolutionary" sentence; it should also mention that there are dissenting opinions, for example the article I linked to before that said "it's not a home run". In my opinion it's better to delete that sentence and add content showing how it's unique (like the second sentence in that paragraph).

The NCCN paragraph can be reduced to a single sentence; something like 'Sipuleucel-T is a "category 1" (highest recommendation) treatment for HRPC in the National Comprehensive Cancer Network (NCCN) Compendium, which is used by Medicare and major healthcare insurance providers to decide whether or not to allow a treatment for patients'. Readers that want to know more about NCCN can then follow the wikilink.

Shubinator (talk) 17:21, 27 August 2010 (UTC)[reply]

Understood. I rearranged the information a bit to ease the flow. Also added links for the references - still learning Wikipedia syntax and conventions - getting there.

Ocyan (talk) 19:09, 27 August 2010 (UTC)[reply]

I think if you used Shubinator's exact suggested sentence above as to the NCCN it would read better and convey more information. JMHO. SaulK (talk) 19:16, 27 August 2010 (UTC)[reply]

Done. I'll be offline until late tonight but keep commenting.

Ocyan (talk) 19:24, 27 August 2010 (UTC)[reply]

I think it looks really good now. What do you think Shubs? SaulK (talk) 21:07, 27 August 2010 (UTC)[reply]

Yep, looks good. I'll port the changes to the live article later tonight. Shubinator (talk) 22:34, 27 August 2010 (UTC)[reply]

Thanks Shubinator and Saul for your help! Ocyan (talk) 02:54, 28 August 2010 (UTC)[reply]

The draft is now live. Thank you for improving the article consistent with our guidelines. Shubinator (talk) 04:14, 28 August 2010 (UTC)[reply]

Shubinator - The new page looks great! Many thanks for helping me learn about writing on Wikipedia.

Ocyan (talk) 11:48, 28 August 2010 (UTC)[reply]