Multifaceted approach addresses pandemic’s threat to prostate cancer care

The coronavirus disease 2019 (COVID-19) pandemic is impacting continuity of care across all areas of medicine. During this challenging period, there are particular obstacles to maintaining delivery of autologous cellular immunotherapy for cancer patients.

Speaking to Urology Times^®, Christina Yi, chief operations officer at Dendreon, discussed the efforts being made by the biotech company and its employees to meet the needs of patients with advanced prostate cancer who have chosen treatment with sipuleucel-T (Provenge).

“These are difficult times for everybody, but if patients with prostate cancer are committed to including sipuleucel-T as part of the fight against their disease, we at Dendreon are in the battle with them,” she said.

With an office located in the first COVID-19 hotspot in the US, Seattle-based Dendreon had early exposure to introducing adjustments to maintain operations in the new environment.

“We quickly recognized that it was not just the safety of our employees that we had to be concerned about by issuing work-from-home orders across all of our facilities. We also had to think about the safety of our patients and all of the potential disruptions that could occur across the entire supply chain involved in delivering sipuleucel-T,” Yi said.

Complex manufacturing process

A course of sipuleucel-T involves 6 visits. The treatment itself consists of 3 doses given by intravenous infusion at 2-week intervals. Two to 3 days prior to each infusion, however, patients must visit a Dendreon-approved collection center where their immune cells are harvested by leukapheresis. This “raw material” that is used to produce sipuleucel-T must be received at one of 2 Dendreon immunotherapy manufacturing facilities (IMFs) within 18 hours. Once those cells are manufactured into Provenge, there is another 18-hour window for the drug to be shipped back so the patient can begin the infusion.

Because cancer patients are at increased risk for COVID-19, Dendreon worked closely with its apheresis network to add additional measures to ensure patient safety. These measures include screening incoming patients regarding recent travel and prescreening to assess patients’ health and well-being.

“Dendreon has more than 150 approved collection centers all over the country. Fortunately, these are primarily community blood centers that are remaining open to support their community’s blood needs during the pandemic. They understand the critical role apheresis plays in the treatment cycle and have gone above and beyond to institute necessary safety precautions to protect their employees, blood donors, and our patients,” Yi said.

Keeping within the strict time frame necessary for transporting blood samples to one of Dendreon’s IMFs, located outside Atlanta, Georgia, and in Orange County, California, and returning the sipuleucel-T doses back to the infusion center has been challenging; the airlines the company usually relies on have had cutbacks in flight routes and fluctuating schedules. To overcome potential problems, alternate modes of transportation are implemented as needed, including the hiring of chartered flights. Dendreon is employing these solutions without passing any of the incurred costs on to patients.

Supporting clinicians

Many physician practices have curtailed staff and operating hours, instead focusing on the most critical patients and delivery of essential treatments. Dendreon has continued to support these practices virtually, from taking on appointment reminders and rescheduling, to employing new virtual tools to replace procedures that typically took place in the office, Yi said.

“Men who had started sipuleucel-T before the pandemic have been committed to completing their treatment, and we are still seeing new patients enroll. We will continue to do all that we can to make sure men can receive their treatment without delay,” she said.