The New Advancement in Treatment of Prostate Cancer - PROVENGE Term Paper

The New Advancement in Treatment of Prostate Cancer - PROVENGE (sipuleucel-T) - Term Paper Example Sadly, according to Vogelzang (1996), metastatic HRPC is responsible for almost all prostate cancer deaths. Medical options currently available for the treatment and management of prostate cancer include radical prostatectomy, radiation therapy, mitoxantrone, estramustine, vinca alkaloids, doxurobicin, and taxanes, among others (Middletone, 1996; Goodin et al., 2002). The choice of therapeutic management, however, is greatly determined by how advanced the disease has become. For instance, studies have shown that radiotherapy and radical prostatectomy could increase survival rate of patients with stage 1 and stage 2 prostate cancers by as much as 95% in the next 5 years but were no longer effective in treating the disease in its metastatic stage (Middleton, 1996). On the other hand, for patients with HRPC, taxane-based chemotherapy has demonstrated a modest survival advantage, but median survival after treatment is only 19 months (Small et al., 2006). Moreover, not all cancer patients are candidates for chemotherapy. Hence, more effective treatment regimens for advanced and metastatic prostate cancer are needed. A more recent advancement in the field of prostate cancer management is the use of the patient’s immune system to combat the disease through the administration of a non-prophylactic cancer vaccine (McNeel, 2007; Sonpavde et al., 2007). Sipuleucel-T, the first ever vaccine that works against late-stage, metastatic, and hormone-refractory prostate cancers, is an autologous cellular immunotherapy specifically designed to stimulate the body’s immune responses (FDA, 2010). This paper highlights sipuleucel-T (tradename: PROVENGEÂ ®) as a novel, nontoxic modality for the treatment of advanced prostate cancer. Specifically, this paper aims to review what sipuleucel-T (PROVENGEÂ ®) is, its components, its side effects, evidences of its effectiveness based on clinical trial studies, and its advantages over some of the existing prostate cancer treat ments. Discussion Among the different immunotherapy approaches investigated in the past, the use of dendritic cells (DCs), which are the main antigen-presenting cells (APCs) of the body, was found to be the most efficient way of presenting cancer antigen to the immune system (Bono et al., 2010). Sipuleucel-T, produced by Dendreon Corporation under the tradename of PROVENGEÂ ®, is a cancer vaccine that makes use of the patient’s own dendritic cells, hence the term autologous immunotherapy, to improve T-cell response (Harzstark and Small, 2009; FDA, 2010). Specifically, each dose of PROVENGEÂ ® contains at least 50 million autologous CD54+ cells activated with a recombinant human protein called PAP-GM-CSF, composed of prostatic acid phosphatase (PAP) and granulocyte-macrophage colony-stimulating factor (GM-CSF) (FDA, 2010). CD54+, a cell surface glycoprotein that functions as a stimulator on APCs, bind to its receptor on the surface of T-cells during the process of antigen pr esentation (CST, 2010). Meanwhile, PAP is a surface antigen expressed in prostate tumor cells. Studies have shown that PAP antigen is relatively specific to prostate epithelium, making it a good target for vaccines (Oh, 2010; Nabhan et al., 2011). On the other hand, GM-CSF is an immune cell activator (FDA, 2010). The CD54+ cells collected from the patient through a process known as leukapheresis, are treated with