title: Improved disease markers suggest dual response in a patient with metastatic castration resistant prostate cancer and chronic lymphocytic leukemia following active cellular immunotherapy.
abstract: Prostate cancer and chronic lymphocytic leukemia (CLL) are relatively common malignancies associated with advanced age. Although immunotherapy-based strategies are used to treat both, currently, there is no overlap in specific therapies. Sipuleucel-T is an active cellular immunotherapy that improves overall survival for patients with metastatic castration resistant prostate cancer (mCRPC) but is not typically associated with a decline in prostate-specific antigen (PSA) following administration. We report the case of a 78-year-old man with mCRPC and Rai stage 0 CLL who sustained a 12-month decline in both PSA and white blood cell (WBC) count following treatment with APC8015-2 (an investigational form of sipuleucel-T), as part of the phase II ProACT clinical trial. Two years later, the patient received commercial sipuleucel-T and again was noted to have a decline in PSA. Exploratory analysis did not clearly identify any peripheral immune markers associated with response. This case report suggests that treatment with sipuleucel-T can rarely lead to PSA decline, may have dual activity against both prostate cancer and CLL, and that these findings warrant further investigation.
authors.affiliation: University of Washington, Seattle, USA. hhcheng@uw.edu.|Fred Hutchinson Cancer Research Center, Seattle, USA. hhcheng@uw.edu.
authors.forename: Heather H
authors.initials: HH
authors.lastname: Cheng
authors.affiliation: University of Washington, Seattle, USA. csoleau@seattlecca.org.
authors.forename: Colleen
authors.initials: C
authors.lastname: Soleau
authors.affiliation: University of Washington, Seattle, USA. evanyu@uw.edu.|Fred Hutchinson Cancer Research Center, Seattle, USA. evanyu@uw.edu.|Division of Medical Oncology, Department of Medicine, University of Washington, Seattle Cancer Care Alliance, 825 Eastlake Avenue E, Seattle, WA, 98109, USA. evanyu@uw.edu.
authors.forename: Evan Y
authors.initials: EY
authors.lastname: Yu
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D017322:Clinical Trials, Phase II as Topic; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000628:therapy*; D008297:Male; D016609:Neoplasms, Second Primary / Q000628:therapy*; D064129:Prostatic Neoplasms, Castration-Resistant / Q000628:therapy*; D014020:Tissue Extracts / Q000627:therapeutic use*
chemical_list: D014408:Biomarkers, Tumor; D014020:Tissue Extracts; C511774:sipuleucel-T