Immunotherapy for Prostate Carcinoma
Publication Date: December 20, 2016
Key Points
Key Points
Prostate cancer remains the most commonly diagnosed malignancy and the second leading cause of cancer death among men in the United States.
Early detection combined with an indolent disease course likely account for the high 5-year survival, approaching 100% for newly diagnosed localized (stage I and II) or regional (stage III) disease.
However, approximately one-third of early stage patients will develop recurrence, often with metastatic (stage IV) disease. For patients with metastatic disease, 5-year survival rates decrease to 28%.
Androgen deprivation therapy (ADT) is the mainstay of initial therapy for metastatic disease, but resistance eventually develops in nearly all men.
In the past 6 years, a number of therapies have been approved for metastatic castration-resistant prostate cancer (mCRPC), including androgen signaling inhibitors (enzalutamide, abiraterone acetate), cytotoxic chemotherapy (cabazitaxel), a radiopharmaceutical (radium-223), and immunotherapy (sipuleucel-T, the first and currently only immunotherapeutic agent approved for mCRPC).
Early detection combined with an indolent disease course likely account for the high 5-year survival, approaching 100% for newly diagnosed localized (stage I and II) or regional (stage III) disease.
However, approximately one-third of early stage patients will develop recurrence, often with metastatic (stage IV) disease. For patients with metastatic disease, 5-year survival rates decrease to 28%.
Androgen deprivation therapy (ADT) is the mainstay of initial therapy for metastatic disease, but resistance eventually develops in nearly all men.
In the past 6 years, a number of therapies have been approved for metastatic castration-resistant prostate cancer (mCRPC), including androgen signaling inhibitors (enzalutamide, abiraterone acetate), cytotoxic chemotherapy (cabazitaxel), a radiopharmaceutical (radium-223), and immunotherapy (sipuleucel-T, the first and currently only immunotherapeutic agent approved for mCRPC).
Immunotherapy for Prostate Cancer
...rapy for Prostate Cancer...
Immunotherapy for non-mCRPC
...herapy for non-mCRPC...
...nt data and accumulated experience...
Selecting Patients for Immunotherapy
...g Patients for Immunotherap...
...role for sipuleucel-T in the management of asymp...
Corticosteroid Therapy, Chemotherapy, and Secondary Hormonal Agents
...Therapy, Chemotherapy, and Secondary Hormo...
...corticosteroid doses equivalent to ≤10mg/day pr...
...ve been treated with abiraterone/corticos...
Sequence of Agents
...ce of AgentsSipuleucel-T first. (90%)...
Sipuleucel-T
...puleucel...
...guidelines for use of sipuleucel-T as...
...A and radiologic monitoring should be followed. (...
...seline PSA and imaging immediately af...
Therapy Subsequent to Sipuleucel-T
...y Subsequent to Sipuleucel-T...
...drafted guidance for industry concerning...
Wait for an event/progression befo...