Leukine in non-metastatic recurrence: good for some

[JimmyToowong]

J Urol. 2006 Jun;175(6):2087-91.

Clinical and immunological characteristics of patients with serologic progression of prostate cancer achieving long-term disease control with granulocyte-macrophage colony-stimulating factor.

Rini BI, Fong L, Weinberg V, Kavanaugh B, Small EJ.

Source

University of California-San Francisco Comprehensive Cancer Center, San Francisco, California, USA. rinib2@ccf.org

Abstract

PURPOSE:

We describe the clinical and immunological characteristics of patients with biochemically relapsed prostate cancer who achieved long-term disease control with GM-CSF (Leukine).

MATERIALS AND METHODS:

A total of 30 patients with prostate cancer and nonmetastatic recurrent disease, as manifested by increasing PSA between 0.4 and 6.0 ng/ml after prior definitive therapy, were enrolled in a phase II trial. Patients received 250 microg/m2 [jm] GM-CSF daily subcutaneously on days 1 through 14 of a 28-day cycle until PSA or objective progression. The patient and disease characteristics of patients who remained without evidence of disease progression beyond 4 years were examined. Additionally, flow cytometry was performed in peripheral blood to characterize monocyte and dendritic cells.

RESULTS:

Seven of 29 evaluable patients (24%) remained free of disease progression at a median of 5.1 years (range 4.5 to 5.6 or greater) from the start of GM-CSF therapy. Patients on long-term GM-CSF tended to have lower initial T stage, Gleason score and pretreatment PSA. An increase in the number of circulating monocytes and dendritic cells was observed after 14 days of GM-CSF treatment. These values returned to baseline during the 14-day off period.

CONCLUSIONS:

GM-CSF modulates PSA in androgen dependent, biochemically relapsed cases. A substantial proportion of patients achieve long-term disease control. The clinical characteristics described may help select patients for future clinical trials with GM-CSF or other immunomodulators. Additional investigation is required to define the immunological mechanism of GM-CSF in prostate cancer.

Comment in

J Urol. 2007 Apr;177(4):1585; author reply 1585-6.

PMID: 16697809 Forum: New agents Title: Leukine in non-metastatic recurrence: good for some

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