Androgen deprivation therapy has provided the backbone of therapy for advanced prostate cancer for decades since the first foray by Huggins and Hodges in 1941.1 Docetaxel was approved for the treatment of metastatic castration-resistant prostate cancer (mCRPC) in 2004 followed by several additional hormonal and immunotherapeutic first-line options in the 2010s.2,3 Among the options, sipuleucel-T was a novel addition as an active cellular immunotherapy using autologous antigen-presenting cells (dendritic cells) activated by a recombinant fusion protein combining prostatic acid phosphatase with granulocyte-macrophage colony-stimulating factor.4 Sipuleucel-T compared with placebo extended overall survival for asymptomatic or minimally symptomatic patients with mCRPC in the IMPACT trial4 by 4.1 months (25.8 vs 21.7 months; P = .03). Notably, 14.5% of patients had received prior docetaxel therapy, and 54.9% received subsequent docetaxel therapy.