New Study Shows Powerful Promise for Vaccine Therapy in Earlier Prostate Cancer

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Dr. Emmanuel Antonarakis, from the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, explains a new study outcome combining androgen deprivation therapy (ADT) with an immunotherapy vaccine, Provenge (sipuleucel-T), in the hope of having greater impact when given to men with "biochemically-recurrent prostate cancer." The study is being reported at the 2013 American Society of Clinical Oncology (ASCO) GU Conference in Orlando.

In this first study testing sequencing of therapy with Provenge and ADT, Dr. Antonarakis explains positive indications that using ADT first followed by Provenge, could be a powerful combination and a possible road to a cure for some men. He stresses, however, that further study is needed. Dr. Antonarakis shares details in this interview with Patient Power's Andrew Schorr.

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:

Hello and welcome to Patient Power.  I’m Andrew Schorr. 

In this program we bring you the latest with an expert in biochemically-recurrent prostate cancer.  Joining us is Dr. Emmanuel Antonarakis.  He’s an assistant professor and a prostate cancer expert at Johns Hopkins Medical Center in Baltimore, Maryland.  Dr. Antonarakis, welcome to Patient Power. 

Dr. Antonarakis:

Thank you very much. 

Andrew Schorr:

Doctor, help us understand, what is biochemically-recurrent prostate cancer?

Dr. Antonarakis:

Biochemically-recurrent prostate cancer is defined as those patients who end up having a PSA elevation following either radical prostatectomy or radiation therapy, or the combination of those two, for localized prostate cancer. 

Andrew Schorr:

Dr. Antonarakis, touch on the sequencing, if you will, of ADT, or Androgen Deprivation Therapy, and the so-called prostate cancer vaccine sipuleucel-T (Provenge). 

Dr. Antonarakis:

The big idea was whether we could use sipuleucel-T (Provenge) earlier in the course of the disease rather than waiting for metastases— reviewing it in patients that have biochemical recurrence but no evidence of metastases to see what is the optimal sequence of conventional hormone therapy with sipuleucel-T (Provenge).  Is it better to give the hormone therapy first followed by the sipuleucel-T (Provenge), or is it better to give the sipuleucel-T (Provenge) first followed by the hormone therapy? 

And based on the immune results that we’ve generated, it appears that the combination where the hormone therapy is given first and the sipuleucel-T (Provenge) is given second is optimal in terms of stimulating the immune response against prostate cancer.  And our hope is that once we have more mature clinical data, which will take at least another 12 months, that what we think we will see, we don’t know if that will be the case, is that the patients that have the augmented immune response will be the ones that have superior clinical responses as well.  Whether or not that ends up being the case remains to be seen, but that is what we expect and hope to see. 

Andrew Schorr:

What does this mean for patients? 

Dr. Antonarakis:

The hope is, that with the optimal combination of standard hormone therapies and novel immunotherapies, that a small percentage of these patients may in fact be cured.  We haven’t yet seen that, but that is what our ultimate goal should be for these patients and that is something that I think I’m hoping for, and we don’t know if that will happen, but I’m hopeful that there will be some patients in the future with the optimal combinations that will potentially be cured with the biochemical recurrent state. 

Andrew Schorr:

Dr. Emmanuel Antonarakis from Johns Hopkins in Baltimore, thank you so much for being with us on Patient Power. 

Dr. Antonarakis:

Thank you very much. 

Andrew Schorr:

I’m Andrew Schorr.  Be sure to sign up for alerts, so you know when we post new programs with the experts.  Thank you for joining us.  Remember, knowledge can be the best medicine of all. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on December 11, 2013