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Treatment options for the advanced asymptomatic prostate cancer patient: an active immunotherapy approach
North Shore Prostate Cancer Consultation and Treatment Service, A Division of North Shore Hematology Oncology Associates, East Setauket, NY
In 2007, prostate cancer is expected to result in nearly 219,000 new cases and more than 27,000 deaths. Many prostate cancer patients with metastatic disease who are resistant to hormonal therapy are asymptomatic for some time. Optimal treatment of these patients has not been determined. Docetaxel (Taxotere) is the only approved chemotherapeutic agent that can increase the survival of these patients, as well as patients with symptomatic, metastatic, androgen-independent prostate cancer. Active immunotherapy approaches have the potential to provide a significant improvement in survival with minimal toxicity. Sipuleucel-T is an investigational autologous active cellular immunotherapy product designed to initiate a T-cell–mediated immune response against a prostate-specific fusion protein prepared by a leukapheresis process using the patient’s own cells. A phase III study of sipuleucel-T demonstrated a 4.5-month improvement in survival (P = 0.010) and a 41% decrease in mortality over 3 years. Sipuleucel-T has been well tolerated and additional studies are in progress. Because of its mild toxicity profile and short course of therapy, sipuleucel-T may be optimally positioned for use prior to docetaxel chemotherapy in treating asymptomatic patients with metastatic prostate cancer.
| Commun Oncol 2007;4:447–452 | full text |  222 kb |