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Abstract

Volume 20, Issue 3 (May 2018) 20, 253–259; 10.4103/aja.aja_9_18

Perspectives on the clinical development of immunotherapy in prostate cancer

Lisa M Cordes1,2, James L Gulley2, Ravi A Madan2

1 Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA
2 Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA

Correspondence: Dr. RA Madan (madanr@mail.nih.gov)

Date of Submission 11-Sep-2017 Date of Acceptance 03-Jan-2018 Date of Web Publication 27-Mar-2018

Abstract

Despite impressive survival benefits with immunotherapy in patients with various solid tumors, the full potential of these agents in prostate cancer has yet to be realized. Sipuleucel-T demonstrated a survival benefit in this population, indicating that prostate cancer is an immunoresponsive disease; however, these results have not been matched by other agents. A large trial with ipilimumab in prostate cancer failed to meet its primary objective, and small trials with PD-1/PD-L1 inhibitors did not yield a significant improvement in overall response. However, several late-stage clinical trials are underway with other vaccines in prostate cancer. Reports of clinical benefit with immunotherapies, particularly when used in combination or a select population, have provided the framework to develop sound clinical trials. Understanding immunogenic modulation, antigen spread, biomarkers, and DNA-repair defects will also help mold future strategies. Through rational patient selection and evidence-based combination approaches, patients with prostate cancer may soon derive durable survival benefits with immunotherapies.

Keywords: checkpoint inhibitor; immunotherapy; prostate cancer; therapeutic vaccine

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