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Randomized Phase II Trial of Sipuleucel-T with or without Radium-223 in Men with Bone-metastatic Castration-resistant Prostate Cancer.

Publication ,  Journal Article
Marshall, CH; Fu, W; Wang, H; Park, JC; DeWeese, TL; Tran, PT; Song, DY; King, S; Afful, M; Hurrelbrink, J; Manogue, C; Cotogno, P; Drake, CG ...
Published in: Clin Cancer Res
March 15, 2021

PURPOSE: To investigate whether radium-223 increases peripheral immune responses to sipuleucel-T in men with bone-predominant, minimally symptomatic metastatic castration-resistant prostate cancer (mCRPC). PATIENTS AND METHODS: A total of 32 patients were randomized 1:1 in this open-label, phase II multicenter trial. Patients in the control arm received three sipuleucel-T treatments, 2 weeks apart. Those in the combination arm received six doses of radium-223 monthly, with sipuleucel-T intercalated between the second and fourth doses of radium-223. The primary endpoint was a comparison of peripheral antigen PA2024-specific T-cell responses (measured by proliferation index). Secondary endpoints were progression-free survival (PFS), overall survival (OS), and PSA responses. RESULTS: We enrolled 32 patients, followed for a median of 1.6 years. Six weeks after the first sipuleucel-T dose, participants in the control arm had a 3.2-fold greater change in PA2024-specific T-cell responses compared with those who received combination treatment (P = 0.036). Patients in the combination arm were more likely to have a >50% PSA decline [5 (31%) vs. 0 patients; P = 0.04], and also demonstrated longer PFS [39 vs. 12 weeks; HR, 0.32; 95% confidence interval (CI), 0.14-0.76] and OS (not reached vs. 2.6 years; HR, 0.32; 95% CI, 0.08-1.23). CONCLUSIONS: Our data raise the possibility of greater clinical activity with the combination of sipuleucel-T and radium-223 in men with asymptomatic bone mCRPC, despite the paradoxically lower immune responses observed. Additional study to confirm these findings in a larger trial is warranted.

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Published In

Clin Cancer Res

DOI

EISSN

1557-3265

Publication Date

March 15, 2021

Volume

27

Issue

6

Start / End Page

1623 / 1630

Location

United States

Related Subject Headings

  • Tissue Extracts
  • Survival Rate
  • Radium
  • Prostatic Neoplasms, Castration-Resistant
  • Prognosis
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies
 

Citation

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Marshall, C. H., Fu, W., Wang, H., Park, J. C., DeWeese, T. L., Tran, P. T., … Antonarakis, E. S. (2021). Randomized Phase II Trial of Sipuleucel-T with or without Radium-223 in Men with Bone-metastatic Castration-resistant Prostate Cancer. Clin Cancer Res, 27(6), 1623–1630. https://doi.org/10.1158/1078-0432.CCR-20-4476
Marshall, Catherine H., Wei Fu, Hao Wang, Jong Chul Park, Theodore L. DeWeese, Phuoc T. Tran, Daniel Y. Song, et al. “Randomized Phase II Trial of Sipuleucel-T with or without Radium-223 in Men with Bone-metastatic Castration-resistant Prostate Cancer.Clin Cancer Res 27, no. 6 (March 15, 2021): 1623–30. https://doi.org/10.1158/1078-0432.CCR-20-4476.
Marshall CH, Fu W, Wang H, Park JC, DeWeese TL, Tran PT, et al. Randomized Phase II Trial of Sipuleucel-T with or without Radium-223 in Men with Bone-metastatic Castration-resistant Prostate Cancer. Clin Cancer Res. 2021 Mar 15;27(6):1623–30.
Marshall, Catherine H., et al. “Randomized Phase II Trial of Sipuleucel-T with or without Radium-223 in Men with Bone-metastatic Castration-resistant Prostate Cancer.Clin Cancer Res, vol. 27, no. 6, Mar. 2021, pp. 1623–30. Pubmed, doi:10.1158/1078-0432.CCR-20-4476.
Marshall CH, Fu W, Wang H, Park JC, DeWeese TL, Tran PT, Song DY, King S, Afful M, Hurrelbrink J, Manogue C, Cotogno P, Moldawer NP, Barata PC, Drake CG, Posadas EM, Armstrong AJ, Sartor O, Antonarakis ES. Randomized Phase II Trial of Sipuleucel-T with or without Radium-223 in Men with Bone-metastatic Castration-resistant Prostate Cancer. Clin Cancer Res. 2021 Mar 15;27(6):1623–1630.

Published In

Clin Cancer Res

DOI

EISSN

1557-3265

Publication Date

March 15, 2021

Volume

27

Issue

6

Start / End Page

1623 / 1630

Location

United States

Related Subject Headings

  • Tissue Extracts
  • Survival Rate
  • Radium
  • Prostatic Neoplasms, Castration-Resistant
  • Prognosis
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies