title: Immunotherapy for prostate cancer: recent advances, lessons learned, and areas for further research.
abstract: A surge of interest in therapeutic cancer vaccines has arisen in the wake of recent clinical trials suggesting that such vaccines can result in statistically significant and clinically meaningful improvements in overall survival-with substantially limited side effects compared with chemotherapy-in patients with metastatic castration-resistant prostate cancer. One of these trials led to the registration of sipuleucel-T, the first therapeutic vaccine to be approved for cancer patients. In this review we highlight emerging patterns from clinical trials that suggest a need for more-appropriate patient populations (i.e., with lower tumor volume and less-aggressive disease) and endpoints (i.e., overall survival) for studies of immunotherapy alone, as well as biologically plausible explanations for these findings. We also explore the rationale for ongoing and planned studies combining therapeutic vaccines with other modalities. Finally, we attempt to put these findings into a practical clinical context and suggest fertile areas for future study. Although our discussion focuses on prostate cancer, the concepts we address most likely have broad applicability to immunotherapy for other cancers as well.
authors.affiliation: Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 10 Center Dr., 8B09 MSC 1750, Bethesda, MD 20892, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Gulley
authors.forename: Charles G
authors.initials: CG
authors.lastname: Drake
mesh_terms: D019496:Cancer Vaccines / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006801:Humans; D007167:Immunotherapy; D008297:Male; D011471:Prostatic Neoplasms / Q000401:mortality / Q000628:therapy*; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019496:Cancer Vaccines