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Immunotherapy for Prostate Cancer

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By Editorial Team

3 min read

Reviewed by: HU Medical Review Board | Last reviewed: July 2024 | Last updated: July 2024

Immunotherapy uses medicine to activate your immune system. Some immunotherapies get your immune system to recognize and destroy prostate cancer cells. These include cancer vaccines and immune checkpoint inhibitors.1

Unfortunately, immunotherapies available for prostate cancer are relatively limited. Current options are only meant for certain people with advanced prostate cancer. Talk to your doctor to see if immunotherapy is right for you. They can discuss the possible risks and benefits with you.1-3

How does immunotherapy work to treat prostate cancer?

Your immune system helps fight disease and infection. Certain white blood cells, called T cells, recognize foreign and damaged cells. They trigger a process that destroys these cells. This process allows your body to destroy germs you are exposed to.4

Immunotherapies for cancer typically train your immune system to identify cancer cells. Cancer cells are not foreign invaders. They are our own cells that have mutated to grow without control. Cancer cells may avoid our body’s immune system by looking like normal, healthy cells.4,5

Immunotherapies work in different ways to treat prostate cancer:1,3

  • Cancer vaccines alter your white blood cells to get them to target prostate cancer cells.
  • Immune checkpoint inhibitors boost your immune response by blocking proteins that reduce immune activity.

Examples

Cancer vaccines

Cancer vaccines are not like normal vaccines. Instead of boosting the immune system to fight infections, they boost it to attack cancer cells. The only cancer vaccine approved to treat prostate cancer is Provenge® (sipuleucel-T).1,3

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Provenge is meant for people with advanced prostate cancer that is not responding to hormone therapy. It is only used when prostate cancer is causing few or no symptoms.1

Provenge is made individually for each person. Your doctor will remove a sample of your white blood cells. They will then send the cells to a lab. In the lab, cells will be mixed with a protein called prostatic acid phosphatase (PAP). When your doctor gets the cells back, they will put the cells back in your body using an infusion into your vein. This trains your immune system to attack the PAP in prostate cancer cells.1

Immune checkpoint inhibitors

Our immune system uses “checkpoint” proteins to keep itself from attacking healthy cells. These proteins act like switches that turn certain immune system cells on or off. Cancer cells can take advantage of these checkpoints to prevent immune system attacks.1

Drugs that target these checkpoints are called “checkpoint inhibitors.” The 2 checkpoint inhibitors used to treat certain rare types of advanced prostate cancer are:1,3

  • Keytruda® (pembrolizumab)
  • Jemperli® (dostarlimab)

These drugs target a checkpoint protein called PD-1. Blocking PD-1 boosts your immune response. The drugs are only meant for people with specific genetic changes. These changes are not common in prostate cancer.1

What are the possible side effects?

Side effects can vary depending on the specific immunotherapy you are getting. The most common side effects of Provenge include:1,6

  • Fatigue
  • Chills
  • Pain in your back or joints
  • Headaches
  • Nausea
  • Fever

Side effects may start during infusion and last a few days.6

The most common side effects of certain immune checkpoint inhibitors include:1

  • Fatigue
  • Cough
  • Nausea or decreased appetite
  • Itching
  • Skin rash
  • Constipation or diarrhea
  • Joint pain

These are not all the possible side effects of immunotherapies. Talk to your doctor about what to expect when getting immunotherapy. You also should call your doctor if you have any changes that concern you when getting immunotherapy.

Other things to know

Follow your doctor’s instructions for receiving immunotherapy. Provenge takes about an hour to infuse and is given 3 times. Each dose is generally given 2 weeks apart. Checkpoint inhibitors for prostate cancer are given as an infusion into the vein, generally every 3 to 6 weeks.1

Provenge usually should not be used if you are taking chemotherapy or immunosuppressive drugs. Certain other drugs you take or specific conditions you have can increase your risk of side effects.1

Before beginning any treatment for prostate cancer, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.

Research on other immunotherapies

Researchers are exploring other immunotherapy options for prostate cancer. These include:2,3

  • Bispecific T-cell engagers – drugs that bring tumor cells in close contact with immune cells
  • Chimeric antigen rreceptor (CAR) T cell therapy – procedure to genetically modify T cells to target cancer cells
  • Cytokines – small proteins that promote immune system function
  • Other immune checkpoint inhibitors – including Yervoy® (ipilimumab), Tecentriq® (atezolizumab), and Opdivo® (nivolumab)
  • Other cancer vaccines

Clinical trials are testing the benefits and risks of some of these treatments in certain forms of prostate cancer. They are also exploring combining some of these immunotherapies with other prostate cancer treatments.2