Prostate Cancer: Practice Management - Episode 9

Immunotherapy for Castration-Resistant Prostate Cancer

The role of immunotherapy for men with castration-resistant prostate cancer (CRPC) is an area that has garnered a great deal of discussion among physicians. E. David Crawford, MD, agrees with the NCCN guidelines, which suggest that sipuleucel-T (Provenge) should be the first-line choice for minimally or asymptomatic CRPC.

Crawford foresees a large paradigm shift in the future for urologists treating CRPC. Multiple new therapeutics, which are easily given by urologists, are rapidly becoming available, such as the immunotherapy sipuleucel-T and the investigational agent radium-223, which Crawford describes as a game changer. Recently approved agents include abiraterone acetate and enzalutamide with TAK-700 (orteronel) and lyase inhibitors rapidly approaching in the development pipeline.

The many different mechanisms of actions for these agents make combinations a viable option. Crawford believes the combination of enzalutamide and abiraterone acetate could result in a game changing powerful option.