Sipuleucel-T and immunotherapy in the treatment of prostate cancer.

INTRODUCTION: Immunotherapy represents an emerging modality of treatment utilized in patients with prostate cancer, among various other malignancies. AREAS COVERED: Sipuleucel-T is an autologous active cellular immunotherapy that has demonstrated improved survival in patients with metastatic castration-resistant prostate cancer (mCRPC). The IMPACT trial led to the FDA approval of sipuleucel-T as first-line treatment for men with asymptomatic or minimally symptomatic mCRPC. Additional immunotherapies in cancer have shown promising results in clinical studies. These include ProstVac, which is a poxvirus vaccine targeting prostate-specific antigen, and cell cycle checkpoint inhibitors of cytotoxic T lymphocyte antigen-4 and programmed death-1 (PD-1) and its ligand (PD-L1). The combination of sipuleucel-T with both androgen deprivation therapy and androgen signaling agents has demonstrated robust and augmented immune responses. The responses to immunotherapy are often seen via different parameters compared with other therapies, including increased T-cell activation and antibody response. EXPERT OPINION: The role of immunotherapy in cancer continues to grow and encompass agents with different mechanisms, and ongoing efforts to identify appropriate timing of therapy and patients for use is integral to the management of prostate cancer.