Cellular Immunotherapy for Prostate Cancer: Lessons Learned From 15 Years of Sipuleucel-T

Abstract

The first cellular cancer immunotherapy, sipuleucel-T, was approved for metastatic castration-resistant prostate cancer (mCRPC) patients 15 years ago. Since then, the therapeutic landscape of advanced prostate cancer has significantly evolved. Sipuleucel-T is a personalized, autologous immunotherapy that activates the patient’s immune system to target prostatic acid phosphatase (PAP)–expressing tumor cells and has demonstrated survival benefit in patients with nonopioid requiring mCRPC. Subsequent clinical trials and abundant real-world data have provided further evidence of this novel immunotherapy’s clinical benefit for patients with mCRPC, as well as demonstrating the numerous immune and biologic responses that sipuleucel-T induces. These data have also identified patient-specific factors associated with longer survival, including race, baseline disease burden, and treatment-induced immune responses. Despite the addition of multiple life-prolonging therapeutic modalities now available to treat patients with mCRPC, the mechanism of action of sipuleucel-T remains unique for patients with advanced prostate cancer. Therefore, maximizing the appropriate clinical utilization of sipuleucel-T in patients with mCRPC within current treatment paradigms is essential.