Antigen spread (AgS) after sipuleucel-T (sip-T): A cross-trial comparison of 4 sip-T clinical trials of patients (pts) with prostate cancer (PC).

Authors

null

Lawrence Fong

University of California, San Francisco, San Francisco, CA

Lawrence Fong , Eric Jay Small , Daniel Peter Petrylak , David I. Quinn , Emmanuel S. Antonarakis , Adam S. Kibel , Nancy N. Chang , Harini Kandadi , Nadeem Anwar Sheikh , Charles G. Drake

Organizations

University of California, San Francisco, San Francisco, CA, Yale University School of Medicine, New Haven, CT, University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, CA, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, Division of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, Dendreon Pharmaceuticals, Inc., Seattle, WA, Columbia University, New York, NY

Research Funding

Pharmaceutical/Biotech Company

Background: Sip-T, an FDA-approved autologous immunotherapy for pts with asymptomatic or minimally symptomatic metastatic castration-resistant PC (mCRPC), is manufactured from peripheral blood mononuclear cells cultured with PA2024, a fusion antigen of prostatic acid phosphatase (PAP) conjugated to granulocyte macrophage colony-stimulating factor. In sip-T–treated pts, antibody responses to PA2024/PAP (target antigens) and AgS (antibody responses to secondary [2°] antigens) correlate with improved OS (Sheikh 2013; GuhaThakurta 2015). We assessed if a greater magnitude of AgS would be observed in an earlier PC disease stage when the immune system is more intact. Methods: Pt serum was from 1 non-metastatic, androgen-dependent PC (ADPC) sip-T trial (STAND, sip-T + androgen deprivation, NCT01431391) and 3 mCRPC sip-T trials (IMPACT, sip-T vs control, NCT00065442; STAMP, sip-T + abiraterone acetate, NCT01487863; STRIDE, sip-T + enzalutamide, NCT01981122). Using a Luminex assay, mean fold-change in IgG responses to target and 2° cancer-related antigens (PSA, LGALS3, LGALS8, ERAS, KRAS, KLK2) was evaluated from baseline to wk 6. Results: AgS was evaluated in 308 pts. The mean fold-change in IgG responses to target antigens was greater for ADPC vs mCRPC pts (p < 0.01). Moreover, the magnitude of IgG responses was greater for most 2° antigens in ADPC vs mCRPC pts (p < 0.05; Table), except for PSA and KLK2 in ADPC vs STRIDE pts. Conclusions: The magnitude ofantibody responses to target and 2° antigens was greater earlier in the PC disease course, consistent with increased antigen-presenting cell activation in ADPC vs mCRPC pts. Increased AgS likely reflects stronger sip-T–induced immune responses, previously associated with extended OS in mCRPC (Sheikh 2013; GuhaThakurta 2015). Future research is warranted on the clinical benefit of sip-T earlier in the PC disease course and the potential impact of androgen suppression on the magnitude of AgS and outcomes. Clinical trial information: NCT01431391; NCT00065442; NCT01487863; NCT01981122

Mean fold-change in response at wk 6 over baseline.

2° antigenIMPACTSTAMPSTRIDE
PSAns
LGALS3
LGALS8
KRAS
ERAS
KLK2ns

p < 0.01, p < 0.05 mean fold-change greater in STAND. ns = not significant.

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Abstract Details

Meeting

2017 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer,Prostate Cancer

Sub Track

Prostate Cancer - Advanced Disease

Clinical Trial Registration Number

NCT01431391; NCT00065442; NCT01487863; NCT01981122

Citation

J Clin Oncol 35, 2017 (suppl 6S; abstract 143)

DOI

10.1200/JCO.2017.35.6_suppl.143

Abstract #

143

Poster Bd #

E21

Abstract Disclosures