Dr. Ana Aparicio Answers Questions About Prostate Cancer and Immunotherapy After the 2021 CRI Virtual Immunotherapy Patient Summit

At the CRI Virtual Immunotherapy Patient Summit in October, patients and caregivers were eager to further their understanding of immunotherapy.

Ana Aparicio, MD, an associate professor at MD Anderson Cancer Center’s Department of Genitourinary Medical Oncology, led the Prostate Cancer and Immunotherapy session.

We followed up with Dr. Aparicio after the event to discuss several more questions from attendees.

Are PSA numbers important to determining if I am eligible for immunotherapy?

Sipuleucel-T. Sipuleucel-T is the only currently approved immunotherapy for prostate cancer. While treatment appears to have greater benefit at earlier stages of metastatic disease, when PSA levels are not too high, there is no cutoff that is used. For clinical trials, PSA numbers are generally not used as eligibility criteria.

Does prostate cancer have to be metastatic to qualify for immunotherapy?

The only approved immunotherapy for prostate cancer is sipuleucel-T. Currently only men with metastatic disease are treated with sipuleucel-T, but numerous clinical trials are evaluating immunotherapy in men with non-metastatic disease.

What, if any, are the advances in treatment of prostate cancer with immunotherapy? Could such treatment be tailored to patients with no metastatic disease, so as to prevent disease advancement?

There are multiple immunotherapy efforts for prostate cancer in clinical trials, including vaccines, immune checkpoint therapy combinations, bispecific T cell engagers, etc. Eventually, yes, I would expect that immunotherapies will be administered earlier in the course of the disease to prevent disease advancement but that is still in the future.

I have stage 4 prostate cancer. It is "stopped" right now and everything in blood work seems "normal".  I am very healthy.  So is there immunotherapy that can or will attack the base and metastasis cancers in my bones?

None approved and it is unlikely that you will be eligible for a clinical trial until the cancer shows signs that it is growing.

Is genomic sequencing valuable? If so, do you recommend it to all of your patients?

Yes, it is valuable, and yes, I recommend it to all of my patients.

I had a prostatectomy in 2016 and a trace was left on the margin, requiring radiation in 2020.  Is immunotherapy helpful to me in the event the radiation didn't completely remove the cancer?

No immunotherapies are approved at this time for this indication but, with time, I expect there should be. 

I was treated for my prostate cancer with proton radiation therapy. If, unfortunately, the cancer were to return, is immunotherapy a viable way to treat the cancer?

The only currently approved immunotherapy for prostate cancer is sipuleucel-T. However, numerous clinical trials are evaluating immunotherapy in men with prostate cancer and I would strongly encourage participation in one if possible. 

Can immunotherapy be used to prevent prostate cancer recurrence?

Not yet but hopefully in the future, it will be. 

I'm currently undergoing immunotherapy (durvalumab). Is it okay to get the COVID-19 vaccine?

In general, yes, but this should be discussed with your treating physician, particularly if you are on a clinical trial. 

At this point, is there any Immunotherapy for prostate cancer considered a CURE?

Not yet but hopefully soon.

Learn more about immunotherapy for prostate cancer