Immunotherapy and Combined Chemotherapy for Castration

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ProSTATE CANCEr Immunotherapy and combined chemotherapy for castration-resistant and metastatic disease two new studies have investigated stable disease in the PPv group, compared novel treatments for patients with with 48% in the emP-alone group. rates castration-resistant prostate cancer, of progression without response were focusing on immunotherapy and 21% for PPv plus emP and 48% for emP combined chemotherapy. a personalized alone, and progression-free survival was peptide vaccine (PPv) provided a 8.5 months and 2.8 months, respectively survival advantage when used alongside (P = 0.0012). no significant difference in estramustine phosphate (emP), and progression-free survival was seen between a combined chemotherapy regimen groups during crossover treatment. the offered a high response rate in metastatic PPv group also showed an advantage in disease, albeit with only similar time- overall survival compared with the emP- to-progression and survival results to alone group. treatment was relatively well- docetaxel monotherapy. tolerated, with more grade 3 toxicities in the the overall survival time compares less emP-alone group than in the PPv group. favorably—perhaps owing to the more- The PPV group also trine Buch-Hansen and co-workers advanced disease of the patients who showed an advantage in overall from Denmark evaluated a combined received DGP. the combined regimen was ‘‘ chemotherapy regimen comprising relatively well-tolerated in both the phase i survival... docetaxel, prednisone and escalating doses and ii trials. the authors believe that of gemcitabine (DGP) in patients with DGP is better than single-agent docetaxel masanori ’’noguchi and colleagues, castration-resistant metastatic prostate in this patient population, especially if from universities in Japan, investigated cancer, finding a promising response rate initiated immediately after the diagnosis of the effect of a PPv—which contained and toxicity profile. this combined regimen metastatic disease, and that phase iii trials four peptides individually selected on the has previously shown efficacy in other of this approach are warranted. basis of their ability to induce a cytotoxic solid tumors. the investigators enrolled t-lymphocyte response in a given 15 patients in an initial phase i study; the Nick Groves-Kirkby patient—on progression-free survival in 3 patients who received the highest DGP selected patients with castration-resistant dose were included alongside 47 additional Original articles Noguchi, M. et al. A randomized phase II trial of personalized peptide vaccine plus low dose prostate cancer. their study randomized a men in a phase ii follow-up study. overall, estramustine phosphate (EMP) versus standard dose total of 57 patients to receive either a PPv 37 (74%) patients exhibited a biochemical EMP in patients with castration resistant prostate cancer. plus low-dose emP, or standard-dose emP response to DGP therapy, with a median Cancer Immunol. Immunother. 59, 1001–1009 (2010) alone, with crossover after progression of time to progression of 7.9 months and a | Buch-Hansen, T. Z. et al. Phase I/II study on docetaxel, disease. no patient in either group showed median overall survival of 13.9 months. gemcitabine and prednisone in castrate refractory metastatic prostate cancer. Cancer Chemother. Pharmacol. a complete response to initial therapy; 75% while this response rate is high compared 66, 295–301 (2010) of patients had either a partial response or to previous trials of docetaxel alone,