The treatment landscape for metastatic castration-resistant prostate cancer (mCRPC) continues to evolve. There are multiple treatments for mCRPC, including sipuleucel-T, the first U.S. FDA-approved immunotherapy, and the androgen receptor–targeting agents (ARTAs) abiraterone acetate and enzalutamide. Sipuleucel-T employs a unique mechanism of action that may be useful in developing a treatment strategy for mCRPC. However, an optimal treatment algorithm for prostate cancer remains undefined. Therefore, survival was compared in men with mCRPC who received sipuleucel-T and an ARTA in the first 6 months of treatment with those who received only ARTA monotherapy.
A retrospective, longitudinal study was conducted using U.S. Medicare Fee-for-Service 100% research identifiable dataset linked to the National Death Index dataset. The study involved eligible men who started their first mCRPC treatment with either sipuleucel-T or ARTA in 2014 or 2015 and had continuous Medicare eligibility for the subsequent 3 years. Findings showed that men who received treatment with both sipuleucel-T and an ARTA (30.4 months), exhibited a longer median survival compared with men who received ARTA without sipuleucel-T (14.3 months). This represents a 28% reduced risk of death with sipuleucel-T based on a multivariate Cox regression modeling analysis. This real-world study of mCRPC treatment indicates that men receiving sipuleucel T and ARTAs can provide improvement in survival, suggesting that leveraging multiple mechanisms of action can be beneficial in treating patients with mCRPC.
Written by: Jason M. Hafron, MD, Chief Medical Officer, Director of Clinical Research, Michigan Institute of Urology, Royal Oak, Michigan