Dr. Garcia on Challenges With Immunotherapy in Prostate Cancer

Jorge A. Garcia, MD, Department of Hematology and Oncology, Cleveland Clinic, discusses some of the challenges with immunotherapy in prostate cancer.

The only immunotherapy agent approved to treat prostate cancer is sipuleucel-T. Moreover, Garcia explains practitioners caution use of sipuleucel-T because it is unclear if it is an active agent, and there are challenges with identifying patients who may benefit from it.

Other challenges with sipuleucel-T include lack of the following: PSA response, response evaluation criteria in solid tumors (RECIST), bone scan improvement, and symptom improvement. However, Garcia says patients are likely to have a better outcome with sipulencel-T than without it.

The next step in overcoming some of these challenges, Garcia predicts, is using sipuleucel-T in combination with oral therapies, such as enzalutamide or abiraterone acetate with prednisone. This could help mitigate side effects without decreasing the efficacy of sipuleucel-T.

Data suggest patients who may benefit from sipuleucel-T are those with low-volume or indolent disease; however, this subset may change if sipuleucel-T is used in combination with other agents.