Advanced Prostate Cancer

Immunotherapy

Immunotherapy is a type of treatment used to repair or boost the body’s immune system to help fight cancer, infections and other diseases. The immune system is your body’s defense against harmful organisms such as bacteria, viruses and cancer cells.

Immunotherapy options

  • Sipuleucel-T (PROVENGE) is the first FDA-approved immunotherapy for metastatic castration-resistant prostate cancer. Classified as a vaccine, this agent improves survival among men with minimal symptoms who have metastatic prostate cancer that is resistant to castration. Sipuleucel-T is made using your own immune cells. Some of your blood is collected at a cell collection center, and a portion of your white blood cells (including immune cells) is separated from the sample, and the rest of the blood is returned to your body (Figure 1). After the collected white blood cells are exposed to a protein found on prostate cancer cells, they are returned to your body through a vein. This process is repeated two more times for a total of three doses of treated cells, usually given two weeks apart. These treated cells cause other immune system cells in your blood to attack the prostate cancer.

Several other types of immunotherapy are currently being studied in clinical trials, some of which show promise in the treatment of many cancer types, including advanced prostate cancer. Talk to your health care team about participating in a trial and how to find one close to you.

Figure 1

Side effects

Sipuleucel-T has relatively few side effects, and most are mild to moderate in severity:

  • Fever
  • Chills
  • Fatigue
  • Back and joint pain
  • Nausea and headache

Acetaminophen (Tylenol) and diphenhydramine (Benadryl) are recommended before each infusion of sipuleucel-T to prevent these side effects. More serious (but rare) infusion reactions may also occur, including shortness of breath, wheezing, dizziness, high blood pressure and stroke.

Monitoring response

It’s difficult to evaluate the effectiveness of sipuleucel-T with currently available tests because even when treatment is effective, this agent does not cause the PSA level to drop or lead to improvement in imaging studies. However, in a large randomized trial, men who received sipuleucel-T lived several months longer on average than men who received an inactive similar vaccine.

Questions about immunotherapy you may want to ask your doctor

  • Could I benefit from immunotherapy?
  • What are the risks of treatment with a cancer vaccine?
  • What are the side effects?
  • How is treatment given?
  • How many treatments will I need?
  • What is the cost of the treatment and does insurance cover it?
  • How often should I have checkups after my treatment?
  • How will immunotherapy affect my recommended treatment?
  • Is there a clinical trial that I may be eligible for?

Additional Sources of Information

 

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