title: Targeted treatment of metastatic castration-resistant prostate cancer with sipuleucel-T immunotherapy.
abstract: BACKGROUND
  Prostate cancer remains highly prevalent and has a poor clinical outcome once metastatic. Sipuleucel-T is an autologous cellular immunotherapy approved for the treatment of metastatic castration-resistant prostate cancer (mCRPC). Sipuleucel-T treatment extends survival but is independent of traditional short-term markers of treatment response observed with chemotherapy and contemporary hormonal treatments. Therefore, it is essential that clinicians understand the mechanism of action of sipuleucel-T and how this can translate in the clinic.
  
  
  OBJECTIVE
  This article aims to summarize the current knowledge of sipuleucel-T therapy and its effects in mCRPC.
  
  
  METHODS
  Relevant publications describing sipuleucel-T clinical data and information relating to immunotherapies were identified.
  
  
  RESULTS
  Treatment with sipuleucel-T extends survival, with side effects being usually mild or moderate and manageable within the outpatient setting. The long-term immune responses generated by sipuleucel-T correlate with a survival benefit. Sipuleucel-T shows a greater magnitude of clinical benefit when used in patients earlier in the mCRPC setting.
  
  
  CONCLUSIONS
  Sipuleucel-T stimulates long-lived immune responses that translate into long-term clinical benefit. The treatment course (three infusions at weeks 0, 2, and 4) is associated with manageable side effects. Short-term markers of future benefit would be clinically useful, and information on effective treatment combinations or sequences is awaited. Sipuleucel-T treatment directs the patient's own immune system to target and remove prostate cancer cells and increases life expectancy. Patients whose cancer is less advanced generally have a more 'active' immune system and may benefit the most from this treatment.
authors.affiliation: Department of Urology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500HB, Nijmegen, The Netherlands, p.mulders@uro.umcn.nl.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Mulders
authors.forename: Maria
authors.initials: M
authors.lastname: De Santis
authors.forename: Thomas
authors.initials: T
authors.lastname: Powles
authors.forename: Karim
authors.initials: K
authors.lastname: Fizazi
mesh_terms: D019496:Cancer Vaccines / Q000627:therapeutic use*; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D008297:Male; D009362:Neoplasm Metastasis; D064129:Prostatic Neoplasms, Castration-Resistant / Q000276:immunology* / Q000628:therapy*; D014020:Tissue Extracts / Q000627:therapeutic use*
chemical_list: D019496:Cancer Vaccines; D014020:Tissue Extracts; C511774:sipuleucel-T