Randomized trial of autologous cellular immunotherapy with sipuleucel-T in androgen-dependent prostate cancer

Tomasz (Tom) Beer, Guy T. Bernstein, John M. Corman, L. Michael Glode, Simon J. Hall, Wayne L. Poll, Paul F. Schellhammer, Lori A. Jones, Yi Xu, Jelle W. Kylstra, Mark W. Frohlich

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    Abstract

    Purpose: Sipuleucel-T, an autologous cellular immunotherapy, was investigated in a randomized, double-blind, controlled trial to determine its biologic activity in androgen-dependent prostate cancer (ADPC). Experimental Design: Patients with prostate cancer detectable by serum prostate-specific antigen (PSA) following radical prostatectomy received 3 to 4 months of androgen suppression therapy, and were then randomized (2:1) to receive sipuleucel-T (n = 117) or control (n = 59). The primary endpoint was time to biochemical failure (BF) defined as serum PSA ≥ 3.0 ng/mL. PSA doubling time (PSADT), time to distant failure, immune response, and safety were also evaluated. Results: Median time to BF was 18.0 months for sipuleucel-T and 15.4 months for control (HR = 0.936, P = 0.737). Sipuleucel-T patients had a 48% increase in PSADT following testosterone recovery (155 vs. 105 days, P = 0.038). With only 16% of patients having developed distant failure, the treatment effect favored sipuleucel-T (HR = 0.728, P = 0.421). The most frequent adverse events in sipuleucel-T patients were fatigue, chills, and pyrexia. Immune responses to the immunizing antigen were greater in sipuleucel-T patients at Weeks 4 and 13 (P <0.001, all) and were sustained prior to boosting as measured in a subset of patients a median of 22.6 months (range: 14.3-67.3 months) following randomization. Conclusions: No significant difference in time to BF could be shown. The finding of increased PSADT in the sipuleucel-T arm is consistent with its biologic activity in ADPC. Long-term follow-up will be necessary to determine if clinically important events, such as distant failure, are affected by therapy. Treatment was generally well tolerated.

    Original languageEnglish (US)
    Pages (from-to)4558-4567
    Number of pages10
    JournalClinical Cancer Research
    Volume17
    Issue number13
    DOIs
    Publication statusPublished - Jul 1 2011

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    ASJC Scopus subject areas

    • Cancer Research
    • Oncology

    Cite this

    Beer, T. T., Bernstein, G. T., Corman, J. M., Glode, L. M., Hall, S. J., Poll, W. L., ... Frohlich, M. W. (2011). Randomized trial of autologous cellular immunotherapy with sipuleucel-T in androgen-dependent prostate cancer. Clinical Cancer Research, 17(13), 4558-4567. https://doi.org/10.1158/1078-0432.CCR-10-3223