The benefits of Provenge before Zytiga make the company look valuable to J&J, they have the clout to promote doing both.
And, it's damn clear that you'd want to do both.
2/3 or Zytiga patients stop because of the side effects, 1/4 of the remainder are dead before the longer survival emerges. That's certainly a huge fraction that would wish they'd done Provenge first.
I think the other points in favor of Provenge going first sound good, but if it were me, it's the last paragraph that would convince me without doubt.
The other points are that Zytiga destroys the immune system so Provenge would be a waste after. I guess I believe this one.
The other claim is that Provenge helps T cell function so Zytiga should work better. Is there hard evidence of this? it's assumed that this must be the case if Provenge is doing what proponents think it does, but again, how good is the evidence?