Prostate Cancer Immunotherapy: Provenge
Immunotherapy is a novel therapeutic approach being studied for treating cancer. Unlike most traditional therapies that attack a cancer directly, active immunotherapies, such as vaccines, are designed to use the patient’s own immune system to fight the cancer.
Provenge (sipuleucel-T), approved by the U.S. Food and Drug Administration in 2010, is a therapeutic cancer vaccine for advanced, metastatic prostate cancer that is no longer responding to hormone therapy (called castration-resistant disease) and that is causing few or no symptoms. Provenge is most commonly given before chemotherapy, but it may also be administered after chemotherapy in selected cases.
This treatment does not lower your prostate-specific antigen (PSA) level or treat prostate cancer symptoms. And, as with hormone therapy and chemotherapy, it has not been shown to cure metastatic prostate cancer. However, it has been shown to prolong life by about four months on average.
Getting Provenge for Prostate Cancer
Provenge is an autologous (made from a patient’s own immune cells) cellular immunotherapy. Each dose is manufactured for a specific patient.
First a machine is used to collect the patient’s white blood cells (immune cells) from his bloodstream in a process known as leukapheresis. In the greater Seattle area, this collection procedure is performed at Puget Sound Blood Center. Then the immune cells are sent to a facility where they are activated by exposure to a protein found in most prostate cancers (prostatic acid phosphatase), which is linked to a protein called GM-CSF that stimulates the immune system. This enhances the response of the immune cells against the cancer. After about 40 hours, the cells are washed, and their immune activity is measured. Finally, about three days after leukapheresis, the patient’s treated immune cells are returned to the cancer clinic and infused into the patient’s bloodstream through an intravenous line. This process is repeated every two weeks for a total of three infusions.
Provenge can be administered at the Seattle Cancer Care Alliance (SCCA) clinic. In fact, SCCA was the location for several of the clinical studies that led to the approval of Provenge.
The most common side effects of Provenge are generally mild and include chills, fatigue, fever, back and joint pain, nausea, and headache. These often start during the Provenge infusions and may last up to a couple of days. They may be treated with acetaminophen or nonsteroidal anti-inflammatory agents.