Sequencing of the various new advanced prostate cancer treatments remains a hot topic in our community. What treatment should come first and will the combination of various treatments be even more effective? These types of questions are constantly buzzing around us and they will continue to as long as we develop new treatments.

The only way to begin to answer these questions is through our continuing to have clinical trials evaluating these questions. In a paper due to be presented at the upcoming annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago, Dr. Antonarakis et al. will share one such trial using ADT and sipuleucel-T (Provenge).

Provenge is currently approved only for the treatment of asymptomatic and minimally symptomatic, metastatic, castration-resistant prostate cancer (mCRPC). There have been many people who have asked why not use Provenge earlier, even before the development of castrate resistance? We know that men who do best with Provenge are those who have the lowest PSA when they receive the treatment. Could earlier use of Provenge yield even better survival?

The paper, “A randomized