Care To Live is very concerned that too many men are again unable to access Provenge. The FDA continues to take its own sweet time inspecting Dendreon’s clean rooms in order that Dendreon be able to provide Provenge to more men now. The FDA fails to recognize the importance of rearranging its priorities, along with the need for taking things out of order sometimes.

In cases such as Provenge, whereby we have an unmet demand for a treatment for late stage cancer where there are no viable alternatives, the old “first in first out”, is not reasonable nor acceptable. Humanity compels this bureaucracy to look at the bigger picture, men’s lives, and to act non-bureaucratically.

Care To Live Inquired of CBER on August 26, 2010

XXXXXXXX

Please feel free to correct us if we are wrong but we understand that Dendreon’s New Jersey Plant is waiting on FDA approval before it can begin using the additional 75% plant capacity.

We understand that you are an extremely busy agency. However, it seems that there are some things that should be given at least some priority over others.

In this case Dendreon is way short of being able to satisfy the demand/need for Provenge. That combined with the fact that Provenge is for a late stage patient population makes timely certification of this plant all the more important.

We would request that CBER make all possible effort to timely certify the plant so as to enable more prostate cancer patients to benefit from this new treatment as soon as possible.

Thank you for the consideration.

Care To Live

________________________________________________

Response on September 1, 2010

Thank you for your recent inquiry to the Food and Drug Administration’s (FDA) Center for Biologics Evaluation and Research (CBER) regarding Provenge. CBER, one of seven centers within FDA, is responsible for the regulation of biologically-derived products, including blood intended for transfusion, blood components and derivatives, vaccines and allergenic extracts, and cell, tissue and gene therapy products.

While we can not discuss specific details with you regarding the Dendreon plant, we appreciate your concerns regarding the availability of Provenge and take them very seriously.  The Agency recognizes the importance of new cellular therapies like Provenge, for serious diseases for which current treatment is unsatisfactory. We will continue to work closely with the manufacturer in its efforts to make Provenge available to the public.
Sincerely,
H.A.
Consumer Safety Officer
Consumer Affairs Branch
Division of Communication and Consumer Affairs
Center for Biologics Evaluation and Research
US Food and Drug Administration

This communication is consistent with 21 CFR 10.85 (k) and constitutes an informal communication that represents my best judgment at this time but does not constitute an advisory opinion, does not necessarily represent the formal position of FDA, and does not bind or otherwise obligate or commit the agency to the views expressed.
__________________________________________

On October 15, 2010

XXXXXXX

The FDA has its new Fast TRACK program but there is no info there about sipuleucel-T (Provenge). Isn’t this supposed to show where the FDA is with regards to inspections?

We can’t figure out why inspection of the additional 75% of capacity of the NJ plant can’t be timely completed. This is a treatment for which demand far exceeds supply and it is for late stage prostate cancer patients.

The FDA’s Fast TRACK program is supposed to provide additional accountability and transparency on the process. Everyone should be entitled to know where the process stands at the FDA regarding this extremely important inspection. Importantly, can’t the process be given some priority considering the circumstances??

Care To Live

______________________

On October 19, 2010

Thank you for your recent inquiry to the Food and Drug Administration’s (FDA) Center for Biologics Evaluation and Research (CBER) regarding Provenge. CBER, one of seven centers within FDA, is responsible for the regulation of biologically-derived products, including blood intended for transfusion, blood components and derivatives, vaccines and allergenic extracts, and cell, tissue and gene therapy products.

While we can not discuss specific details with you regarding the Dendreon plant, we appreciate your concerns regarding the availability of Provenge and take them very seriously.  The Agency recognizes the importance of new cellular therapies like Provenge, for serious diseases for which current treatment is unsatisfactory. We will continue to work closely with the manufacturer in its efforts to make Provenge available to the public.

If you have further questions regarding the availability of Provenge, you may contact the manufacturer, Dendreon Corp., directly at www.dendreon.com or 877-336-3736 regarding their product.

We hope this information is helpful.

Sincerely,
H.A.
Consumer Safety Officer
Consumer Affairs Branch
Division of Communication and Consumer Affairs
Center for Biologics Evaluation and Research
US Food and Drug Administration

Popularity: 31%

The real story—the tragedy in this case, and the one yet to be told by the so-called “Mainstream Media”—is the story of the needless three-year delay in availability of Dendreon’s Provenge for our sons, fathers, and grandfathers.

The Dendreon Investor Village (IV) message board at www.investorvillage.com(link) is where a group of the most well-informed people in the world on all-things-Dendreon, exchange information. Many have posted there non-stop since early in the decade. One daily post entitled “Daily Death Count”, documents the number of men who have died of prostate cancer since “Black Wednesday” (link to Mark Thornton op ed), May 8, 2007, the date the FDA went against the recommendation of its own Advisory Committee and refused to approve Provenge. As of this past Thursday, the date Provenge received final approval, the death count stood at 90,055. Every one of these 90,055 men were deeply loved and now dearly missed by their families and friends.

It’s difficult to ignore the fact that the March 29, 2007 Provenge Advisory Committee voted unanimously (17-0) that the drug is SAFE, or the fact that the same Committee voted minutes later, (13-4) that the drug “demonstrated substantial evidence of efficacy,” the federally mandated standard in such reviews. But the FDA did. The FDA also ignored the fact that the treatment was being submitted to help men with end stage prostate cancer, the stage for which there is no viable treatment option. Provenge would have been their last resort. Continue Reading The Real Provenge Story »

Popularity: 50%

March 11, 2010

Dr. Sharfstein,

Can you please check with CBER and see why it is taking them so long to make a final decision on Dendreon’s Provenge.

The pending BLA is an amended BLA that was first submitted to the FDA in 2006. Following a March 2007 AC, in which the FDA hand picked experts overwhelmingly voted for approval, CBER decided to require additional proof of efficacy. That additional proof, as set forth in the SPA, was in fact obtained by Dendreon with results being announced in April 2009 (interim data was also positive and the IDMC also recommended approval in October 2008).

Now CBER has had all the new clinical data from the IMPACT trial as of July 2009 and all the CMC data since October 2009. Despite promises from CBER to the advocacy group CareToLive and others that they would review this treatment, intended for late stage prostate cancer, expeditiously, the treatment inexplicably remains unavailable.

This review is hardly being done expeditiously. FDA has now delayed this treatment from reaching patients for 3 years.

Please inquire/help.

Kerry M. Donahue, Esq.

Counsel for CareToLive

Dublin, Ohio

CTL Petition for reconsideration of May 2007 decision to issue CR filed in July 2007.

Popularity: 13%

This letter was delivered by Fed Ex to our Attorney, Kerry Donahue, today, 01-11-10, at around 1 PM.

Download the letter here >>  cberletterofresponsetocaretolive.pdf

(Click on to enlarge)

Popularity: 12%

FDA’s CBER Gone Fishing While Men Gone Wishing

Read it here http://www.nowpublic.com/health/fdas-cber-gone-fishing-while-men-gone-wishing 

Popularity: 12%

FDA’S Cber Sipping New Year’s Champagne Burst Patient’s Bubbles

http://my.nowpublic.com/health/fdas-cber-sipping-new-years-champagne-burst-patients-bubbles

Popularity: 12%

November 23, 2009

SENT BY FACSIMILE AND U.S. MAIL

Citizen Petition -2007-P-168

Karen Midthun, MD
Acting Director of CBER
Food and Drug Administration
1401 Rockville Pike
200N
Rockville, MD 20852

Dear Karen Midthun, MD ,

I am representing and speaking for an advocacy group by the name of CareToLive. The group CareToLive filed a Citizen Petition with the CBER division of the FDA on July 26, 2007. That Petition asked for a reconsideration of the May 2007 denial of a license for distribution of Provenge, made by Dendreon Corporation. Provenge is a treatment for late stage prostate cancer, which is a patient class without appealing treatment options.

While your office denied that petition in early 2009 you did indicate that when your office did obtain the remaining data requested from Dendreon (the results of the IMPACT trial), that, as stated several times in your Petition response, CBER would expeditiously review that data.

The last line of the CBER response said:
“We look forward to receiving Dendreon’s amendment to its existing BLA so that we may review this information expeditiously.”

While we were disappointed that CBER did not end the IMPACT trial based on the interim data provided by the Independent Data Monitoring Company (IDMC) that CBER was presented with in mid 2008, as that was clearly additional confirmation that Provenge was safe and effective, so that the patients who are in great need could have started receiving Provenge much sooner, we remain hopeful of expeditious review now that the trial was completed and you have all the data.

Now, 2 ½ years after the original AC panel of experts voted to approve Provenge you have been provided a response by Dendreon to your then issued CR letter. You now have all the new data requested as of October 30, 2009 which was the day Dendreon completed its rolling aBLA submission.

We are writing you this letter to remind you of the promises made in your response to the CareToLive Citizen Petition to review the data expeditiously. Please devote whatever resources you can to this evaluation so that it can be timely completed. Remember that this is no ordinary application; rather it is an application for approval of a treatment for end stage prostate cancer for which viable treatment options do not exist.

We at CareToLive get e-mails and letters from patients and their families every week who desperately want Provenge for themselves or their loved ones. Some of the stories we hear are heartbreaking. Having Provenge approved by Christmas of 2009 would provide much hope and joy to these patients and their families at a time of year when joy is needed. Recently we lost one of our advocates, Bruce Tower to late stage prostate cancer. Mr. Tower got a placebo in the IMPACT trial. We understand that at the beginning not everyone that wants Provenge will be able to get it, but we have to start somewhere. Approval by Christmas would be an act worthy of much praise and many advocates including CareToLive will praise such effort as we understand you would need to work diligently for such an extraordinary and very humane effort to occur.

If you think the timetable for approval of Provenge by Christmas is impossible, then please explain why it is impossible so that we can try to understand. While I know you are extremely busy folks there, this is a treatment for which the original BLA was filed (and voted to be approved by experts soon thereafter) in November 2006.

If expeditious review is something that you no longer think your division is capable of, then we would like to meet with you to discuss it. We will come to Rockville for such a meeting (or anywhere else you like). We would like the meeting to be held one or two weeks after Christmas, if you are available. We would like to bring several board members from CareToLive as well as about 5 other prostate cancer advocates including Thomas Farrington (PHEN).

If approval can be completed expeditiously there is probably little reason for the post Christmas meeting to occur. If that approval is impossible within that time and you do not estimate approval in the days or week thereafter then these advocates would very much like to meet with you so as to discuss the issues involved with the inability to move expeditiously as promised in your Citizen Petition response, on the amended BLA for Provenge.

Thank you very much for your time and consideration of this matter.

Sincerely,

Kerry Donahue

Popularity: 10%

Hold the deck.

It’s certainly okay to have the opinion that the FDA made a reasonable choice at the time it denied approval to Provenge in 2007. It’s not the right opinion, but it is a defendable one. It is not all right, based on what we now know, to say they made the right decision.

On the other hand:

That the Provenge BLA was not afforded proper due process is an absolute. Because it clearly was not afforded proper due process nobody can say with any certainty that the FDA made a reasonable decision. Once the process is corrupted it’s all guesswork from there. Nobody knows for sure the extent of influences and back room shenanigans that occurred to assure that Provenge was not fairly evaluated. When CareToLive through litigation and FOIA’s tried to get information they were stymied by the FDA who went to great lengths to avoid any transparency on the issue.

There are aces scattered all over the floor at the FDA and a couple sticking out of a few sleeves so how can the game have been fairly played? Is it too much to ask for a fair game? The denial of a fair PROCESS is the one truth that the FDA could have, should have, admitted.

If that process occurred in a court room there would, at a minimum, have been declared a mistrial, when the evidence of such became known (which was made known to the FDA by petition, litigation and of course lots of letters).

That they did not make a reasonable and common sense decision based on the class of patients for which Provenge was seeking approval, or conduct a proper risk/benefit analysis with a focus on the fact that the treatment was destined for late stage patients is clear.

The FDA said two things that support this; One was that the minority voices on the AC panel were taken into consideration as a factor in the decision making process, and Two is that Richard Pazdur of CDER influenced that process. Top that off with an FDA commissioner who just happens to be a very good friend of Milken……

I don’t want the point to be lost that it is the position of CareToLive that there is no way anyone can say a reasonable decision was made, because the process was completely corrupted. CareToLive has sought accountability and transparency to determine in what ways the process fell short. If the FDA would show us the process then we might be persuaded otherwise. Until then and even because of the cover up itself, it has to be evaluated based on what we know.

The cover up and the lack of transparency is indicative that the FDA made a choice that transparency would make matters worse in this case. Otherwise, why fight so hard to keep the process from the public eye.

What other influences entered into the picture. Political pressure? Milken pressure? Financial pressure? Inside power struggles? Some or all of the above?

The deck was stacked. The dice were loaded. Everybody knows!

With all that you now know about Milken and the depths of his depravity, does it not trouble you that he had considerable control and influence over at least Scher, Martin and von Eschenbach if not others? Continue Reading American Hold ‘Em »

Popularity: 15%

MOTION FOR LEAVE TO CONDUCT/COMPLETE DISCOVERY UNDER CIVIL RULE 56(f)
AND PARTIAL MEMORANDUM CONTRA TO DEFENDANT FDA’S MOTION FOR SUMMARY JUDGMENT

Now Comes Plaintiff, CareToLive, on behalf of its members and all suffering late stage prostate cancer patients and their families who have now been denied a proven safe and effective treatment for over two years and request leave from this Court to conduct a limited amount of discovery so as to more fully respond to the Motion for Summary Judgment filed by Defendant, as further set forth in the attached memorandum.

Link to Motion >> ctlfoiaresponse6-06-09c.pdf

Popularity: 15%

http://youtube.com/watch?v=6Q0uQAL_YDA

Video of Care To Live member Ted Girgus taken at our nationwide protest in Seattle. Ted has stage IV prostate cancer, that has metastacized to his bones. Ted and his doctor, want him on Provenge NOW!

* * * * *

Here is a Video of the 2007 Rally

http://www.youtube.com/watch?v=UqAx7uZAS90

MAY 30, 2008 NATIONWIDE PROSTATE CANCER PROTEST

* * * * *

20% of 42,000 Lives = 8,400 Lives & Counting

Money is very important to most people yet nobody can measure how many dollars one life is worth. There is no amount of money, no matter how much, that is worth trading for one single life. If one life is so very valuable to one family, then how much are 8,400 lives worth?

Ever since the FDA delayed getting Provenge to men with late stage prostate cancer over 42,000 men have died. If they were on Provenge since May 2007, at least 20% would still be alive. That is over 8,400 men that would have benefited.

In other words the FDA would have approved Provenge if it saved 9,240 people, but because it only saved 8,400 people’s lives, they won’t let us have it. The bureacracy must be using artificial intelligence to come up with their faulty conclusion to delay. The FDA already told us the agency is too broken to keep up with the science.

There are currently 90,000 to 100,000 men with Androgen Independent Prostate Cancer (AIPC), or are hormone refractory. That’s 18,000 to 20,000 people. AT LEAST THEY COULD BE SAVED, according to interim data just released. Keep in mind that the final data will even be more impressive.

CareToLive has again written to Dr. Jesse Goodman, the Director of the Center for Biologics Evaluation and Research (CBER) at the Food and Drug Administration (FDA). CareToLive sent Dr. Goodman a Citizens Petition on July 27, 2007, to reconsider the denial of a license for Provenge, an immunotherapy treatment for men with late stage prostate cancer. The petition was sent to the FDA over a year ago and as per Federal Regulation CareToLive should have received an answer within 180 days after receipt. We are still waiting.

Additional data for Provenge has recently been evaluated and has shown what we at CareToLive have been saying all along. Provenge is safe and Provenge shows a survival benefit. An outside firm has just confirmed that 20% of the men in the Provenge trials survived over placebo, due to the Provenge treatment. It is time for the FDA to grant approval, even if only conditional while more data is gathered, so that men with late stage prostate cancer can begin receiving Provenge NOW!

Link to CareToLive’s Citizen’s Petition http://caretolive.com/caretolivepetition.pdf

Here is the letter CareToLive sent to Dr. Jesse Goodman:

Jesse L. Goodman, M.D., M.P.H.
Director
Food and Drug Administration
Center for Biologics Evaluation and Research
1401 Rockville Pike
Rockville, MD 20852-1448

Re: Docket No. 2007P-0297/CP1

Dear Dr. Goodman,

I am requesting that the FDA reconsider our CareToLive Citizens Petition docket number 2007P-0297/CP1 filed in July 2007, concerning the FDA delay of Provenge licensure for men with late stage prostate cancer. To date we have never received a proper answer and have only received one letter from you, stating that our petition is still pending. Enclosed is additional data obtained from the Independent Data Monitoring Committee (IDMC) from the Interim look, proving that the survival is real. Provenge clearly demonstrated a 20% reduction in the risk of death in the Provenge arm relative to placebo.

My husband Mike Kearney and I both spoke to Paul Richards of the FDA Consumer Affairs CBER Department, whom your office directed us to. He is supposed to be working for Consumer Affairs but he obviously does not have the consumer in mind. Mr. Richards stated that he himself looked at the data and did not see the survival. This is shocking, seeing that even Dr. Maha Hussain, of “leaked letter” fame said at the meeting that she saw the survival. She wanted to make sure it could be attributed to Provenge. This additional IDMC data proves that the survival is indeed due to Provenge. Mr. Richards refused to answer our question as to whether Provenge is safe. The IDMC clearly states that Provenge is safe, and the FDA Advisory Commmitee voted unanimously that Provenge is safe, so that should not be an issue, despite Mr. Richards refusal to admit Provenge’s safety profile. Mr Richards told us that the minority panelists swayed the FDA decision to delay Provenge. Another of the minority panelists, Dr. Howard Scher, also of “leaked letter” infamy, had many undisclosed conflicts of interest, including running a competitior’s trial for prostate cancer with Novacea’s Asentar, a trial that was stopped midstream due to the high number of deaths, possibly caused by Dr. Scher’s trial design, which caused an abundance of toxicity to the poor patients enrolled.

Our Citizens Petition, which is also attached, addressed the shenanigans that took place during the FDA Provenge BLA process. The FDA correctly granted Provenge Fast Track Status and Priority Review since it is a treatment for a life threatening disease where no viable alternatives exist. Regardless of what took place in the past, in light of the corroborating scientific evidence seen at the Interim, it is time to to reconsider our Petition concerning the denial of a license for Provenge for men with late stage prostate cancer.

To date, over 42,000 men have died without the benefit of Provenge. A 20% improvement in survival means that more than 8000 of them might still be alive if given the right to fight for their lives. It is a travesty that the FDA, which is sworn to protect the public health, has instead ignored these men in their battle with prostate cancer.

The FDA can fix this by allowing the 96,000 men who are eligible for Provenge right now, the chance to fight for their lives. Please restore the American people’s faith in the FDA, and in light of the new data, honor that Fast Track Status and Priority Review. Please reconsider the CareToLive Citizens Petition to reconsider the denial of a license for Provenge. This is an emergency!

Thank you for your immediate consideration of this matter.

Very Respectfully,

Rory & Mike Kearney
CareToLive,
a not for profit corporation

Cc: Division of Dockets Management (HFA-305)
Paul Richards, FDA Consumer Affairs
Lanessa Hill, FDA Consumer Affairs
Stephen Ripley, FDA Consumer Affairs

Popularity: 13%