Immunotherapy for Prostate Cancer

Immunotherapy is a hot area in cancer treatment. When it comes to prostate cancer, there are a few immunotherapy treatments, and they only help in certain cases. But researchers are constantly looking for new ones.

The two immunotherapy medications approved to treat prostate cancer are sipuleucel-T (Provenge) and pembrolizumab (Keytruda). Here’s what to know about them and other medications that researchers are studying.

Prostate Cancer Treatment Vaccine

Prostate cancer turns off your T cells, which are part of your immune system. Your medical team might be able to switch them back on with a vaccine called sipuleucel-T (Provenge). It’s not a vaccine that prevents prostate cancer; it’s a way to treat the cancer.

Provenge can’t help everyone who has prostate cancer. It might be an option for you if:

  • You have few or no symptoms.
  • Hormone therapy for your prostate cancer hasn’t helped. That treatment uses drugs or surgery to change your body’s hormone balance, in hopes it will make it harder for cancer to grow.
  • Your prostate cancer has spread to other parts of your body.

Doctors are testing Provenge to see if it can help people whose prostate cancer is in the early stage.

You get Provenge through an IV in several sessions. It’s tailor-made for you, using your own immune cells.

First, your medical team hooks you up to a machine that filters some of the immune cells out of your blood. You go back home; the sample of cells goes to a lab. The staff exposes it to a protein that stimulates the cells and programs them to fight prostate cancer.

About 3 days later, you visit your medical team again. They give the powered-up cells back to you in an IV.

You repeat the process about 2 weeks later, and again about 2 weeks after that.

Provenge doesn’t slow the cancer down or treat symptoms. Nor does it lower your level of PSA, a protein in your blood that signals prostate cancer. But it might help you live longer.

If you have side effects from Provenge, they would probably start soon after you get the IV of the treated cells. The most common side effects are symptoms like the flu, such as fever, chills, nausea, or general aches. They should go away in about 3 days and are usually mild to moderate.

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Targeting PD-1 for Prostate Cancer

Your immune cells have a protein on them that stops them from attacking normal cells. You might hear your doctor call it PD-1. A drug called pembrolizumab (Keytruda) can block it, allowing your immune system to take on the cancer.

You’d get this medication by IV every 2-3 weeks. If it causes side effects, you might:

  • Feel tired.
  • Be sick to your stomach.
  • Feel itchy.
  • Get a skin rash.
  • Lose your appetite.
  • Have diarrhea.
  • Be constipated.
  • Get pains in your joints.

It’s not common, but Keytruda might cause worse side effects. That happens if it lets your immune system attack a healthy part of your body, like your lungs, intestines, or kidneys. Tell your medical team about any symptoms. They may have to take you off Keytruda and give you medicine to stop the side effects.

Treatments in Research

Scientists are working on other immunotherapy treatments for prostate cancer. The prospects include:

A pair of drugs that work in a similar way to Keytruda. They help the immune cells get around substances that would block them from attacking the cancer. One is called nivolumab (Opdivo). Like Keytruda, it keeps the PD-1 protein out of your immune cells’ way. The other half of the pair is ipilimumab (Yervoy). It blocks another protein that gets in the way, CTL-4. The drug combo has shown promise in initial tests, but it needs more trials.

PROSTVAC is a treatment vaccine that powers up immune cells to attack cancer. It works a lot like Provenge does. One big study didn’t pan out. But doctors are trying it out as a combo with other drugs, including Yervoy.

GVAX is a drug made from prostate cancer cells that are exposed to radiation. They make GM-CSF, a protein that helps immune cells grow. Doctor are testing GVAX paired up with other drugs.

Researchers test potential treatments in clinical trials. If you’re interested in finding out about prostate cancer clinical trials for immunotherapy, you can ask your doctor and check the federal website clinicaltrials.gov. If you do find a trial that looks like a good match, talk with your doctor about what’s involved, including the risks and benefits.

WebMD Medical Reference Reviewed by Minesh Khatri, MD on October 15, 2019

Sources

SOURCES:

Prostate Cancer Foundation: “Immunotherapy for Prostate Cancer.”

American Cancer Society: “Immunotherapy for Prostate Cancer,” “What is Cancer Immunotherapy?”

Cancer Support Community: “Immunotherapy for Prostate Cancer.”

National Institute of Allergy and Infectious Diseases: “Overview of the Immune System.”

National Cancer Institute: “NCI Dictionary of Cancer Terms,” “Prostate Cancer Treatment -- Patient Version,” “Sipuleucel-T.”

Cleveland Clinic: “Prostate Cancer: Management and Treatment.”

Scope (Stanford Medical School): “Pioneering immunotherapy drug gets new testing for early prostate cancer.”

FDA: “Questions and Answers -- Provenge.”

MD Anderson Cancer Center: “Immunotherapy combination generates responses against castration-resistant metastatic prostate cancer.”

Clinicaltrials.gov.

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