- Immune therapies such as sipuleucel-T can be considered along the spectrum of disease progression; potential benefits and expectations for “response” should be addressed with the patient prior to therapy.
- Antitumor efficacy of sipuleucel-T might be enhanced by the use of other immunologic/biologic therapies, including checkpoint inhibitors and vaccines, or by the use of drugs that may affect the intratumoral milieu within bone, such as radium-223 or other bone-seeking agents. These treatments are currently under study in clinical trials.
- Sipuleucel-T should not be used in the neoadjuvant setting or for patients with progressive and/or symptomatic prostate cancer.
- The benefit of sipuleucel-T in the setting of biochemically relapsed prostate cancer remains uncertain at this time; a frank discussion regarding the lack of data to support its role in this early stage of disease is needed.