A transient increase in eosinophils is associated with prolonged survival in men with metastatic castration-resistant prostate cancer who receive sipuleucel-T

Douglas G. McNeel, Thomas Gardner, Celestia S. Higano, Philip W. Kantoff, Eric J. Small, Mark H. Wener, Robert B. Sims, Todd DeVries, Nadeem A. Sheikh, Robert Dreicer

Research output: Contribution to journalArticle

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Abstract

Sipuleucel-T is an autologous cellular immunotherapy used to treat asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer (mCRPC). Traditional short-term indicators of clinical response commonly used with chemotherapy have not correlated with survival in patients treated with sipuleucel-T. This retrospective study aimed to evaluate laboratory parameters as possible early biomarkers associated with clinical benefit following sipuleucel-T treatment. Patients treated with sipuleucel-T from three randomized, controlled, phase III clinical trials in mCRPC were considered: IMPACT (NCT00065442; n = 512), D9901 (NCT00005947; n = 127), and D9902A (NCT01133704; n = 98). Patients from these trials were included in this study if their samples were analyzed by the central laboratory and if data were available from baseline and ≥ 1 posttreatment time point (n = 377). We found that sipuleucel-T treatment was associated with a transient increase in serum eosinophil count at week 6 that resolved by week 14 in 28% of patients (105 of 377). This eosinophil increase correlated with induced immune response, longer prostate cancer-specific survival [HR, 0.713; 95% confidence interval (CI), 0.525-0.970; P = 0.031], and a trend in overall survival (HR, 0.753; 95% CI, 0.563-1.008; P = 0.057). Median serum globulin protein levels also increased transiently, which was associated with antigen-specific antibody responses; however, this finding did not correlate with longer survival. We conclude that transient increases in eosinophils at week 6 may be a useful, objective, short-term indicator of global immune activation and survival benefit with sipuleucel-T in patients with mCRPC. This observation warrants prospective evaluation in future clinical trials.

Original languageEnglish (US)
Pages (from-to)988-999
Number of pages12
JournalCancer immunology research
Volume2
Issue number10
DOIs
StatePublished - Oct 1 2014

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Castration
Eosinophils
Prostatic Neoplasms
Survival
Confidence Intervals
Serum Globulins
Phase III Clinical Trials
Immunotherapy
Antibody Formation
sipuleucel-T
Blood Proteins
Retrospective Studies
Biomarkers
Clinical Trials
Antigens
Drug Therapy
Therapeutics
Serum

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A transient increase in eosinophils is associated with prolonged survival in men with metastatic castration-resistant prostate cancer who receive sipuleucel-T. / McNeel, Douglas G.; Gardner, Thomas; Higano, Celestia S.; Kantoff, Philip W.; Small, Eric J.; Wener, Mark H.; Sims, Robert B.; DeVries, Todd; Sheikh, Nadeem A.; Dreicer, Robert.

In: Cancer immunology research, Vol. 2, No. 10, 01.10.2014, p. 988-999.

Research output: Contribution to journalArticle

McNeel, Douglas G. ; Gardner, Thomas ; Higano, Celestia S. ; Kantoff, Philip W. ; Small, Eric J. ; Wener, Mark H. ; Sims, Robert B. ; DeVries, Todd ; Sheikh, Nadeem A. ; Dreicer, Robert. / A transient increase in eosinophils is associated with prolonged survival in men with metastatic castration-resistant prostate cancer who receive sipuleucel-T. In: Cancer immunology research. 2014 ; Vol. 2, No. 10. pp. 988-999.
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abstract = "Sipuleucel-T is an autologous cellular immunotherapy used to treat asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer (mCRPC). Traditional short-term indicators of clinical response commonly used with chemotherapy have not correlated with survival in patients treated with sipuleucel-T. This retrospective study aimed to evaluate laboratory parameters as possible early biomarkers associated with clinical benefit following sipuleucel-T treatment. Patients treated with sipuleucel-T from three randomized, controlled, phase III clinical trials in mCRPC were considered: IMPACT (NCT00065442; n = 512), D9901 (NCT00005947; n = 127), and D9902A (NCT01133704; n = 98). Patients from these trials were included in this study if their samples were analyzed by the central laboratory and if data were available from baseline and ≥ 1 posttreatment time point (n = 377). We found that sipuleucel-T treatment was associated with a transient increase in serum eosinophil count at week 6 that resolved by week 14 in 28{\%} of patients (105 of 377). This eosinophil increase correlated with induced immune response, longer prostate cancer-specific survival [HR, 0.713; 95{\%} confidence interval (CI), 0.525-0.970; P = 0.031], and a trend in overall survival (HR, 0.753; 95{\%} CI, 0.563-1.008; P = 0.057). Median serum globulin protein levels also increased transiently, which was associated with antigen-specific antibody responses; however, this finding did not correlate with longer survival. We conclude that transient increases in eosinophils at week 6 may be a useful, objective, short-term indicator of global immune activation and survival benefit with sipuleucel-T in patients with mCRPC. This observation warrants prospective evaluation in future clinical trials.",
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AU - Wener, Mark H.

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AU - Dreicer, Robert

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