Current status of immunological therapies for prostate cancer

Emmanuel S. Antonarakis, Charles G. Drake

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of Review: Considerable progress has been made in prostate cancer immunotherapy over the last year, and two agents have completed phase III testing. This review will discuss the most promising immune-directed strategies in development for prostate cancer, outlining interventions that mitigate tumor-induced tolerance and highlighting several combination immunotherapy approaches. Recent Findings: A pivotal phase III study using Sipuleucel-T, an autologous prostatic acid phosphatase (PAP)-loaded dendritic cell immunotherapy, in men with metastatic castration-resistant prostate cancer (CRPC) demonstrated a survival advantage over placebo. By contrast, two phase III studies of GVAX, an allogeneic tumor cell vaccine, in a similar patient population failed to show a survival benefit of GVAX or GVAX/docetaxel over standard docetaxel/ prednisone. Other strategies currently in clinical development include the ProstVac poxviral vaccine, a PAP-encoding DNA vaccine, and immune checkpoint inhibitory approaches. Summary: Although Sipuleucel-T may receive FDA approval for patients with metastatic CRPC, challenges remain in identifying immunotherapy strategies that overcome immune tolerance, especially when disease burden is substantial. An emerging paradigm focuses on using immunotherapy together with checkpoint antagonists or in combination with conventional therapies in patients with early-stage disease. Such approaches are likely to yield optimal results, but must carefully be explored in well designed phase II studies before moving forward.

Original languageEnglish (US)
Pages (from-to)241-246
Number of pages6
JournalCurrent opinion in urology
Volume20
Issue number3
DOIs
StatePublished - May 2010

Keywords

  • Immune checkpoints
  • Immunotherapy
  • Prostate cancer
  • T-cell
  • Vaccine

ASJC Scopus subject areas

  • Urology

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