How Do Chemotherapy Modulating Agents Work?

Chemotherapy modulating agents are a class of drugs used to treat asymptomatic or minimally symptomatic metastatic castrate-resistant (hormone-refractory) prostate cancer.

The only drug that belongs to this class is “sipuleucel-T,” an autologous, personalized cellular immunotherapy (a type of vaccine) created from the body’s immune system cells which works by inducing the immune system to attack prostate cancer cells.

Sipuleucel-T is prepared individually from the patient’s immune cells (white blood cells) that have been treated in the laboratory with granulocyte-macrophage colony-stimulating factor (a type of growth factor) and a protein found on prostate cancer cells.

Chemotherapy modulating agents are administered as a suspension (liquid) to be injected intravenously (into a vein) over 60 minutes, typically once every two weeks for a total of three doses.

About three days before each dose of sipuleucel-T injection is to be given, a blood sample is taken at a cell collection center using a procedure called leukapheresis (a process that removes white blood cells from the body). This procedure takes about three to four hours. The sample is then sent to the manufacturer and combined with a protein to prepare a dose of sipuleucel-T injection. 

Chemotherapy modulating agents work in the following ways:

• They belong to a class of medications called “autologous cellular immunotherapy,” a type of medication prepared using cells from the patient’s blood.
• They work by inducing the body's immune system to fight the cancer cells.
• They selectively target the prostate-specific antigen known as a prostatic acid phosphatase that is expressed in approximately 95% of prostate cancers.

Chemotherapy modulating agents are used to treat asymptomatic or minimally symptomatic prostate cancer with metastases that are resistant to standard hormone treatment.

Some of the common side effects include:

• Nausea
• Vomiting
• Constipation
• Diarrhea
• Headache
• Increased sweating
• Muscle/back pain
• Tiredness/weakness
• Loss of appetite
• Pain/swelling at the injection site

Other rare side effects include:

• Dizziness 
• Shortness of breath
• Fatigue 
• Fever
• Anemia (low red blood cell count)
• Peripheral edema (swelling of lower legs or hands)
• Hematuria (presence of blood in urine)
• Muscle spasms 
• Hypertension (high blood pressure)
• Weight loss
• Tremor (an involuntary, rhythmic muscle contraction leading to shaking movements in one or more parts of the body)
• Urinary tract infection
• Insomnia 
• Rash/hives/itching

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of chemotherapy modulating agents include:

• Provenge
• Sipuleucel-T