Overall survival in metastatic castration-resistant prostate cancer (mCRPC): A retrospective electronic medical record analysis of men treated with sipuleucel-T in community urology over 14 years.
e17041 Background: Treating mCRPC remains challenging, with limited options for prolonging overall survival (OS). Sipuleucel-T, an autologous prostate-specific antigen (PSA)-targeting cellular immunotherapy (therapeutic vaccine), was FDA-approved in April 2010. We examined the outcomes of treatment for mCRPC since 2010 in SoNaR for Prostate Cancer, the deidentified PPS Analytics/Specialty Networks Uro-oncology electronic medical record (EMR) database that encompasses 90 United States (US) community urology practices with over 3,200 providers. Methods: This multicenter, retrospective study analyzed OS in 2 cohorts of men aged ≥18 years who were diagnosed with mCRPC between January 1, 2010 and May 31, 2024 and treated (Cohort 1) or not treated (Cohort 2) with sipuleucel-T in community urology settings. For the preliminary covariates of race, US region, and age and Gleason group scores at diagnosis, patient characteristics were summarized descriptively, Kaplan-Meier (KM) methods and log-rank tests compared OS, and Cox proportional hazards estimated hazard ratios (HRs). Results: Of a total 11,265 men, 46.9% received sipuleucel-T (Cohort 1). Data from the the sipuleucel-T-treated cohort are described in text; all patients are described in the table. Mean age was 73.4 years, 14% were Black, and 46% were in the Southern US region (Table). At PC diagnosis, the mean Gleason score was 7.3, categorizing 53% as high-risk. At mCRPC diagnosis, the mean PSA level was 49.1 ng/mL (median 6.3 ng/mL). Median OS was 44 months (Table). Among the 4,494 patients of cohort 1 with known status, 28% were still alive 5 years after treatment; their median OS was 97 months. Conclusions: Despite their high-risk disease, patients who received sipuleucel-T had a 44-month median OS, with 28% being alive at 5 years later. This highlights the potential therapeutic benefit of integrating sipuleucel-T into real-world treatment for mCRPC. Further analysis is needed, leveraging the rich nature of this dataset. Supported by Dendreon Pharmaceuticals, LLC. Patient characteristics and outcomes. Overall (n=11,265) Cohort 1Sipuleucel-T (n=5,281) Cohort 2No Sipuleucel-T(n=5,984) P -value, Cohort 1 vs 2 Median age, years 76 74 78 <0.001 Race, % (White/Black/Other) 67/15/19 69/14/17 65/15/21 <0.001 US region, % (Midwest/Northeast/South/West) 25/16/45/14 25/16/46/13 26/16/44/14 0.124 PSA at mCRPC diagnosis (mean/median) 81.1/8.0 49.1/6.3 110.0/10.3 <0.001 Gleason score at PC diagnosis, mean 7.3 7.3 7.2 0.064 Alive at 5 years, % 20% 28% 12% <0.001 KM OS (median, 95% CI), months 33 (32, 34) 44 (43, 46) 24 (24, 25) HR (95%CI), Cohort 1 vs 2 1.7 (1.6-1.8)<0.001 CI, confidence interval.
Authors
- Jason Hafron (ORCID: https://orcid.org/0000-0003-0866-797X)
- Bryan A. Mehlhaff
- Nicholas Lazarou
- Paul Sieber (ORCID: https://orcid.org/0000-0002-6064-9683)
- Lawrence I. Karsh (ORCID: https://orcid.org/0000-0002-3095-8303)
- Benjamin Lowentritt (ORCID: https://orcid.org/0000-0002-2921-6249)
- Katie Grant
- Paul Monk (ORCID: https://orcid.org/0000-0002-0508-2987)
- Nadeem A. Sheikh (ORCID: https://orcid.org/0009-0000-8926-136X)
- Lorraine O'Donnell
- Bart J. Wilson (ORCID: https://orcid.org/0000-0001-5770-0102)
- Matthew Harmon (ORCID: https://orcid.org/0009-0003-0068-1117)
- Christopher Michael Pieczonka (ORCID: https://orcid.org/0000-0003-2827-8226)
- Neal D. Shore (ORCID: https://orcid.org/0000-0001-5767-0548)
- Michael D. Fabrizio
- Arpit Kashyap
- Margaret Warner-Lubin
Institutions
- Dendreon (United States) (US)
- The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (US)
- Urology of Virginia (US)
- Michigan Institute of Urology (US)
- Chesapeake Urology Associates (US)
- Cardinal Health (United States) (US)
- Dermatology Specialists (US)
- Oregon Urology Institute (US)
- Carolina Urologic Research Center (US)
- The Ohio State University (US)
Publication Details
- Journal
- Journal of Clinical Oncology
- Published
- 2025-05-28
- DOI
- https://doi.org/10.1200/jco.2025.43.16_suppl.e17041
- Primary Topic
- Prostate Cancer Treatment and Research
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Dendreon Pharmaceuticals