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Combination immunotherapy with prostatic acid phosphatase pulsed antigen‐presenting cells (provenge) plus bevacizumab in patients with serologic progression of prostate cancer after definitive local therapy
Author(s) -
Rini Brian I.,
Weinberg Vivian,
Fong Lawrence,
Conry Shauna,
Hershberg Robert M.,
Small Eric J.
Publication year - 2006
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21956
Subject(s) - medicine , prostatic acid phosphatase , prostate cancer , prostate specific antigen , elispot , immunotherapy , urology , prostate , bevacizumab , antigen , cancer , gastroenterology , oncology , immunology , chemotherapy , cd8
BACKGROUND APC8015 (sipuleucel‐T) is a cellular prostate cancer vaccine containing autologous antigen‐presenting cells (APC) loaded with PA2024, a recombinant prostatic acid phosphatase/granulocyte‐macrophage–colony‐stimulating factor fusion protein, as the immunogen. Bevacizumab is a recombinant antibody against vascular endothelial growth factor, a proangiogenic protein with inhibitory effects on APC. A clinical trial was conducted to determine the prostate‐specific antigen (PSA) and immunomodulatory effects of this combination immunotherapy. METHODS Patients with androgen‐dependent prostate cancer who had received prior definitive therapy with nonmetastatic, recurrent disease as manifested by a rising PSA of between 0.4 ng/mL and 6.0 ng/mL were enrolled. APC8015 was given intravenously(i.v.) on Weeks 0, 2, and 4. Bevacizumab was given at a dose of 10 mg/kg i.v. on Weeks 0, 2, 4, and every 2 weeks thereafter until toxicity or disease progression. PSA changes were recorded and the PSA doubling time (PSADT) was calculated. Immune response versus PA2024 was measured at baseline and after treatment by T‐cell proliferation and interferon‐γ enzyme‐linked immunospot (ELISPOT) assays. RESULTS Twenty‐two patients were treated. One patient achieved a ≥50% decrease in PSA. Nine patients exhibited some decrease in PSA from baseline, ranging from 6% to 72%, with the PSA of 3 patients decreasing at least 25%. The median pretreatment PSADT for the 20 evaluable patients was 6.9 months and the median posttreatment PSADT was 12.7 months ( P = .01). All patients demonstrated induction of an immune response against PA2024. CONCLUSIONS The combination of APC8015 and bevacizumab induces an immune response and modulates PSA in patients with biochemically recurrent prostate cancer. Cancer 2006. © 2006 American Cancer Society.