Sipuleucel-T improves survival in mCRPC in real world

The use of sipuleucel-T significantly prolongs overall survival (OS) in men with metastatic castration-resistant prostate cancer (mCRPC), regardless of treatment setting, based on real-world data presented at ASCO GU 2020.

“In these unadjusted initial analyses, we observed longer survival in men receiving sipuleucel-T … compared with that observed in men receiving the oral agents, abiraterone or enzalutamide, in both first and any-line [treatment] settings,” said the researchers.

Using claims data from the Medicare Fee for Service (FFS) Identifiable Research, the researchers retrospectively analysed patients with mCRPC who received either sipuleucel-T (n=656, median age 76 years [for first-line] and n=922, median age 75 years [for any-line]) or oral agents* (n=4,916, median age 78 years [for first-line] and n=5,203, median age 78 years [for any-line]). [ASCO GU, abstract 42]

Patients who received sipuleucel-T had a significantly longer median OS than those on oral agents in the first-line (35.0 vs 21.0 months; hazard ratio [HR], 0.57, 95 percent confidence interval [CI], 0.508–0.635; p<0.0001) or any-line treatment settings (35.2 vs 20.7 months; HR, 0.55, 95 percent CI, 0.498–0.603; p<0.0001).

The 36-month survival rate was significantly higher in patients treated with sipuleucel-T compared with oral agents, regardless of whether they are used in the first-line or any-line treatment settings (49 percent vs 29 percent; p<0.0001 or 48 percent vs 28 percent; p<0.0001, respectively).

Sipuleucel-T recipients also demonstrated a reduced risk of death at 43 percent for first-line and 45 percent for any-line treatment settings. “This magnitude of risk reduction is a compelling finding, and additional analyses are underway looking at other variables that could impact outcomes,” said lead author Dr Rana McKay from Moores Cancer Center, University of California in San Diego, California, US.

“Real-world analyses like this can provide insight into OS differences when comparing cohorts receiving treatment regimens for mCRPC that have not been studied in clinical trials,” said the researchers, who added that “future research will use multivariate analyses to explore how various factors impact survival outcomes, including factors previously described to impact outcomes in the mCRPC setting.”

“[Furthermore,] these real-world data contribute to a growing body of evidence that … [sipuleucel-T] continues to deliver on its promise of helping men with advanced prostate cancer live longer,” said Dr Bruce Brown, chief medical officer at Dendreon Pharmaceuticals, in a press release.