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  • Title: Targeted treatment of metastatic castration-resistant prostate cancer with sipuleucel-T immunotherapy.
    Author: Mulders PF, De Santis M, Powles T, Fizazi K.
    Journal: Cancer Immunol Immunother; 2015 Jun; 64(6):655-63. PubMed ID: 26025563.
    Abstract:
    CONTEXT: Prostate cancer remains highly prevalent and has a poor clinical outcome once metastatic. Sipuleucel-T is an autologous cellular immunotherapy approved for the treatment of metastatic castration-resistant prostate cancer (mCRPC). Sipuleucel-T treatment extends survival but is independent of traditional short-term markers of treatment response observed with chemotherapy and contemporary hormonal treatments. Therefore, it is essential that clinicians understand the mechanism of action of sipuleucel-T and how this can translate in the clinic. OBJECTIVE: This article aims to summarize the current knowledge of sipuleucel-T therapy and its effects in mCRPC. EVIDENCE ACQUISITION: Relevant publications describing sipuleucel-T clinical data and information relating to immunotherapies were identified. EVIDENCE SYNTHESIS: Treatment with sipuleucel-T extends survival, with side effects being usually mild or moderate and manageable within the outpatient setting. The long-term immune responses generated by sipuleucel-T correlate with a survival benefit. Sipuleucel-T shows a greater magnitude of clinical benefit when used in patients earlier in the mCRPC setting. CONCLUSIONS: Sipuleucel-T stimulates long-lived immune responses that translate into long-term clinical benefit. The treatment course (three infusions at weeks 0, 2, and 4) is associated with manageable side effects. Short-term markers of future benefit would be clinically useful, and information on effective treatment combinations or sequences is awaited. Sipuleucel-T treatment directs the patient's own immune system to target and remove prostate cancer cells and increases life expectancy. Patients whose cancer is less advanced generally have a more 'active' immune system and may benefit the most from this treatment.
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