Prolonged PSA stabilization and overall survival following sipuleucel-T monotherapy in metastatic castration-resistant prostate cancer patients.
Prostate Cancer Prostatic Dis
; 22(4): 588-592, 2019 12.
Article
in En
| MEDLINE
| ID: mdl-30980027
ABSTRACT
BACKGROUND:
Sipuleucel-T is an autologous cellular immunotherapy that is FDA approved for the treatment of asymptomatic or minimally symptomatic metastatic castrate-resistant prostate cancer (mCRPC). The IMPACT registry trial demonstrated a 4.1 month survival benefit, but not a consistent PSA response or improvement in progression-free survival. Based upon several factors, including this lack of objective treatment response, sipuleucel-T has been under-utilized in this patient population, despite current NCCN recommendations.METHODS:
In order to explore if delayed treatment response occurs in a subset of patients, we performed a single institutional retrospective analysis of mCRPC patients treated with sipuleucel-T and ongoing ADT alone. Within that group, we then identified a subset of sipuleucel-T-treated men with long-term disease control and no additional interventions. To independently confirm this finding, we evaluated a total of 336 patients from 4 large urology group practices treated with sipuleucel-T between 2010 and 2014 and identified 44 patients who met the same criteria and demonstrated evidence of PSA stabilization post sipuleucel-T treatment.RESULTS:
For this subgroup of patients, 79% (95% CI 64.5%, 88.1%) survived 36 months with a median time to subsequent therapy of 17.8 months (95% CI 10.3, 25.3).CONCLUSIONS:
Although patient selection could account for some or all of these results, these data support the utilization of sipuleucel-T alone in select mCRPC patients that is associated with a delay in disease progression and a good overall prognosis.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tissue Extracts
/
Kallikreins
/
Prostate-Specific Antigen
/
Cancer Vaccines
/
Prostatic Neoplasms, Castration-Resistant
/
Immunotherapy
Type of study:
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Aged80
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Prostate Cancer Prostatic Dis
Journal subject:
ENDOCRINOLOGIA
/
NEOPLASIAS
/
UROLOGIA
Year:
2019
Type:
Article
Affiliation country:
United States