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June 20, 2017. Another another study generating news at this month’s ASTRO looked at channeling the immune system to target prostate cancer. This Phase III double-blind randomized trial published in JCO compared ipilimumab (CTLA-4 antibody) with placebo for chemo-naive metastatic castrate-resistant prostate cancer patients who have little or no symptoms. The trial was negative in terms of its primary endpoint of median overall survival: 28.7 (experimental arm) vs 29.7 months (control arm). However, progression-free survival (PFS) was significantly improved with ipi at 5.6 vs 3.8 months indicating a potential role for taping the immune system in future prostate cancer studies. But with rates of 15% grade ≥ 3 diarrhea and 33% grade ≥ 3 immune-related toxicities in the ipi arm, the benefit of PFS alone probably doesn’t outweigh the risk in otherwise asymptomatic patients.