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Clinical predictors of survival in patients with castration-resistant prostate cancer receiving sipuleucel-T cellular immunotherapy.
- Source :
-
Cancer chemotherapy and pharmacology [Cancer Chemother Pharmacol] 2017 Sep; Vol. 80 (3), pp. 583-589. Date of Electronic Publication: 2017 Jul 20. - Publication Year :
- 2017
-
Abstract
- Background: We evaluated the patterns of progression and determined clinical predictors of survival in patients with castration-resistant prostate cancer (CRPCa) who received sipuleucel-T.<br />Methods: We retrospectively analyzed 56 consecutive patients with asymptomatic or minimally symptomatic CRPCa treated with sipuleucel-T. Age, number of bone metastases, history of prior systemic treatment, and alkaline phosphatase level (ALP) were tested as predictors of survival in a multivariate Cox proportional hazards regression model. The Kaplan-Meier method was used to estimate event-free probabilities.<br />Results: The 56 patients were a median age of 67 years (range 51-84 years). After sipuleucel-T treatment, 25 patients developed bone progression after a median of 22 months of follow-up (54% of patients were event free at 2 years) and 10% (6/56 patients) developed rapid progression. Eleven deaths were observed after a median of 28 months of follow-up. Forty-eight patients were included in the multivariate analysis for overall survival. The analysis showed that age >70 years (p = 0.012), number of bone metastases >20 (p = 0.018), prior systemic treatment (p = 0.018), and ALP level >90 IU/L (p = 0.010) significantly predicted worse overall survival. Two-year overall survival was 36% among the 16 patients with two or more of these factors and was 93% among the 32 patients with one or none of these factors (p = 0.0004).<br />Conclusions: CRPCa patients with age (>70 years), increased tumor burden in bone (>20 metastases and/or elevated ALP level), and/or prior systemic treatment are more likely to experience rapid deterioration after sipuleucel-T. These results need to be prospectively validated.
- Subjects :
- Aged
Aged, 80 and over
Humans
Male
Middle Aged
Prostatic Neoplasms, Castration-Resistant mortality
Retrospective Studies
Survival Analysis
Tissue Extracts administration & dosage
Tissue Extracts pharmacology
Immunotherapy methods
Prostatic Neoplasms, Castration-Resistant drug therapy
Tissue Extracts therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1432-0843
- Volume :
- 80
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Cancer chemotherapy and pharmacology
- Publication Type :
- Academic Journal
- Accession number :
- 28730293
- Full Text :
- https://doi.org/10.1007/s00280-017-3391-9