Autologous Cellular Immunotherapy (Provenge) for Treating Prostate Cancer

Proprietary name: Provenge®

Generic name: Sipuleucel-T

Prostate cancer, a slowly growing tumor that most often affects men older than age 60, is associated with malignant transformation and uncontrolled growth of prostate gland cells. Initial malignant transformation of cells may be followed by accumulation of mutations in several genes, such as tumor suppressor genes p531 and PTEN2,with a resulting increase in tumor growth and metastatic dissemination. Most (95%) prostate cancers are adenocarcinomas. Risk factors for prostate cancer include the following:

Typically, prostate cancer is diagnosed during screening; it can also be an incidental finding of histopathologic examination of tissue removed during palliative transurethral prostate resection. Screening for prostate cancer includes the prostate-specific antigen (PSA) test and digital rectal examination.

If prostate cancer is suspected following initial screening, biopsies are performed. Patients with persistently elevated PSA levels and negative biopsy results typically undergo repeat biopsy.

Histopathologic examination of biopsy material may use several classification characteristics, most commonly Gleason score, a glandular architecture-based grading of tumors. Gleason score uses a sum of the two most common patterns of tissue architecture. Grading of each pattern is based on the degree of abnormality, from 1 (near normal) to 5 (absence of normal glandular pattern). The resulting definition is either low-grade, well-differentiated tumor (score 2 to 4), moderate-grade, moderately differentiated tumor (score 5 to 7), or high-grade, poorly differentiated tumor (score 8 to 10).

Staging of prostate cancer is based on a tumor node metastases staging system and...