Prostate Cancer Vaccine Increases Survival

Survival improved if followed by hormone therapy

TUESDAY, July 15 (HealthDay News) -- Men with non-metastatic, castration-resistant prostate cancer have better survival when receiving a vaccine followed by hormone therapy, according to the results of a study published in the July 15 issue of Clinical Cancer Research.

Ravi Madan, M.D., and colleagues from the National Institutes of Health in Bethesda, Md., randomized 42 patients with non-metastatic, castration-resistant prostate cancer to a poxvirus-based prostate-specific antigen (PSA) vaccine or the androgen receptor antagonist nilutamide. Patients with rising PSA but no evidence of metastasis had the option of receiving both treatments.

The researchers found that median survival was 4.4 years, with the group initially receiving the vaccine tending to have a longer median survival (5.1 versus 3.4 years). Median survival was significantly better for 12 patients who initially received vaccine and later received nilutamide than for eight patients who initially received nilutamide and later received vaccine (6.2 versus 3.7 years). Patients initially receiving vaccine had significantly improved survival if they had less advanced disease (Gleason score of 7 or less), PSA less than 20 ng/dL, or prior radiation treatment, the report indicates.

"These data indicate that patients with non-metastatic castration-resistant prostate cancer (D0.5) who receive vaccine prior to second-line hormone therapy may potentially result in improved survival as compared to patients who receive hormone therapy and then vaccine," Madan and colleagues conclude.

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