Volume 16, Number 3Review ArticlesThe Rationale for Optimal Combination Therapy With Sipuleucel-T for Patients With Castration-resistant Prostate CancerTreatment ReviewMark EmbertonRobert B SimsNeil MariadosVladimir MouravievChristopher M PieczonkaRaoul S ConcepcionNeal D ShoreImmunotherapy encourages the recipient’s own immune response to destroy cancer cells, and current evidence suggests that immunotherapies may be most beneficial in early metastatic castration-resistant prostate cancer (mCRPC). Sipuleucel-T is the first therapeutic cancer vaccine to be approved by both the US Food and Drug Administration and European Medicines Agency for the treatment of asymptomatic or minimally symptomatic mCRPC. Combining immunotherapy with other treatments may have potent anticancer effects; cytoreductive therapies can release tumor antigens and promote a proinflammatory environment that could augment immunotherapies. However, some cytoreductive agents or coadministered drugs may be immunosuppressive. Understanding these interactions between different mCRPC treatment modalities may offer further potential to improve patient outcomes. [Rev Urol. 2014;16(3):122-130 doi: 10.3909/riu0637] © 2014 MedReviews®, LLCProstate cancerSipuleucel-TCombination therapy
Volume 17, Number 4Review ArticlesSipuleucel-T for the Treatment of Patients With Metastatic Castrate-resistant Prostate Cancer: Considerations for Clinical PracticeTreatment UpdateDimitrios TelonisDavid AlbalaVladimir MouravievChristopher M PieczonkaSipuleucel-T treatment is associated with a significant and consistent survival benefit in patients with metastatic castrate-resistant prostate cancer. Most adverse events are infusion related, manageable, and of short duration. Early screening and diagnosis of metastatic disease is important, as the greatest survival benefit may occur in patients with a lower disease burden. The short duration of sipuleucel-T treatment facilitates the use of subsequent therapies. Sipuleucel-T is now being used in the clinic for patients with a lower disease burden. We present our own experience with the use of sipuleucel-T in the setting of a large urology practice. [Rev Urol. 2015;17(4):203-210 doi: 10.3909/riu0671] © 2016 MedReviews®, LLCImmunotherapyMetastatic castrate-resistant prostate cancerSipuleucel-TClinical
Volume 18, Number 1Practice ProfileAssociated Medical Professionals, Syracuse, NYNeil F MariadosDavid M. AlbalaChristopher M Pieczonka[Rev Urol. 2016;18(1):35-37 doi: 10.3909/riu0710] © 2016 MedReviews®, LLC
Volume 20, Number 2Original ResearchEffectiveness of Subcutaneously Administered Leuprolide Acetate to Achieve Low Nadir Testosterone in Prostate Cancer PatientsPrzemyslaw TwardowskimStuart AtkinsonDeborah M Boldt-HouleJoseph Renzulli IIJason HafronChristopher M PieczonkaScott EggenerEvidence suggests lower nadir testosterone levels during the first year of androgen deprivation therapy improve advanced prostate cancer clinical outcomes. We evaluated pivotal trials for subcutaneously administered leuprolide acetate (1-, 3-, 4-, and 6-month doses) to determine nadir testosterone levels. Pooled analysis showed 99%, 97%, and 91% of patients reached nadir testosterone ≤20, ≤10, and ≤5 ng/dL respectively (median ≤3 ng/dL). Across all available categories, ≥88% of patients reached nadir testosterone ≤5 ng/dL, and <3% experienced a microsurge. Achievement and maintenance of low nadir testosterone levels may improve progression-free survival and time to onset of castrate-resistant prostate cancer. [Rev Urol. 2018;20(2):63–68 doi: 10.3909/riu0798] © 2018 MedReviews®, LLCProstate cancerAndrogen deprivation therapyLHRH agonistsLeuprolide acetateNadir testosterone