Sipuleucel-T: Sipuleucel-T is an autologous vaccine prepared by isolating dendritic cells from peripheral blood of patients. The isolated dendritic cells are activated in vitro with PAP-GM-CSF fusion protein and then transfused back to produce an active immune response against PAP to kill prostate cancer cells. A placebo-controlled, small sample phase III study showed that treatment with Sipuleucel-T prolonged the overall survival of CRPC patients. In the IMPACT study (phase III), 512 asymptomatic or minimally symptomatic patients with mCRPC were randomized 2:1 to the sipuleucel-T group (341 patients) and the placebo group (171 patients), with no visceral metastases and with no prior chemotherapy for more than 3 months. The median survival was 25.8 months in the Sipuleucel-T group and 21.7 months in the placebo group (HR=0.78, p=0.03), and treatment with sipuleucel-T reduced the risk of death by 22%, but did not improve treatment efficiency or time to disease progression. The results of the IMPACT study confirmed that immunotherapy prolongs survival in CRPC patients. Therefore, the FDA approved sipuleucel-T for the treatment of patients with asymptomatic or mildly symptomatic mCRPC (mHRPC).