Granulocyte macrophage colony-stimulating factor is a pleiotropic cytokine capable of inducing systemic immune responses against experimental and human tumors. GM-CSF stimulates the differentiation of hematopoietic progenitors to monocytes and neutrophils, and reduces the risk for febrile neutropenia in cancer patients. GM-CSF also has been shown to induce the differentiation of myeloid dendritic cells (DCs) that promote the development of T-helper type 1 (cellular) immune responses in cognate T cells. This review summarizes some of the immunological effects of GM-CSF relevant to antitumor immunity in cancer patients. GM-CSF has been used to augment the activity of rituximab in patients with follicular lymphoma and to induce autologous antitumor immunity in patients with hormone-refractory prostate cancer. A number of studies and reports focus on its activity, alone or in combination, for prostate cancer. It has been used with thalidomide, revlimid, provenge and a variety of other drugs and vaccines as an immunolodulator. It remains in active investigation, and clinicaltrials.gov lists 43 trials of various kinds with Leukine in prostate cancer. It is not recommended by any guideline or consensus statement.
J. A. Garcia, P. Triozzi, S. Smith, B. I. Rini, T. Gilligan, D. Peereboom, P. Elson, E. Klein, R. Dreicer Abstract Phase I/II study of lenalidomide and GM-CSF in hormone refractory prostate cancer (HRPC). No: 229 2007 Prostate Cancer Symposium
Prostate Cancer Immunology: Biology, Therapeutics, and Challenges
W. S. Webster, E. J. Small, B. I. Rini, and E. D. Kwon
JCO November 10, 2005 23:8262-8269
Immunotherapeutics in Development for Prostate Cancer
A. L. Harzstark andE. J. Small
The Oncologist April 1, 2009 14:391-398