Leonard Gomella, MD, chair, Department of Urology, director, Kimmel Cancer Center Network, Thomas Jefferson University Hospital, provides an update on the dendritic cell vaccine sipuleucel-T (Provenge) in castration-resistant prostate cancer (CRPC).
Interest in sipuleucel-T is beginning to expand, as a result of data accumulating in the phase IV PROCEED registry, Gomella states. This registry was designed to provide further information on survival and the risk of cerebrovascular events following the administration of sipuleucel-T.
Previous data suggested that patients over the age of 80 with CRPC who received treatment with sipuleucel-T had worse outcomes when compared to younger patients because of a potential depletion of immune cells. However, new data presented at the 2014 Genitourinary Cancer Symposium from the PROCEED registry demonstrated that immune parameters following the administration of sipuleucel-T were identical in older patients and younger patients, Gomella states.
Adding to this information on immune response were results from a post-hoc subset analysis from the pivotal IMPACT trial, which demonstrated that treatment with sipuleucel-T results in a humoral antigen spread that correlates with improved outcomes, Gomella notes. In the antigen spread process, following treatment induced cell lysis, the immune response broadens overtime resulting in the activation of multiple cancer-related antigens, which extends the immune response. Although this is preliminary data, it shows that treatment with sipuleucel-T is continuing to evolve in CRPC, Gomella believes.
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