Using Hiltonol® to treat prostate cancer patients on active surveillance

Inclusion Criteria:

* Written informed consent and HIPAA authorization for release of personal health information.

NOTE: HIPAA authorization may be included in the informed consent or obtained separately.

* Age \> 18 years at the time of consent.
* ECOG Performance Status of 0-1 within 14 days prior to being registered for protocol therapy (Study Procedure Manual).
* Histologically confirmed adenocarcinoma of the prostate (with previous diagnostic tissue available for tumor marker analysis).
* • ISUP Grade 1(Gleason 3+3) and Grade 2 (Gleason 3+4) and Grade 1 (Gleason 3+3, with PSA≥10, or stage ≥ T2b)
* Estimated life expectancy is ≥ 10 years
* Candidate for primary curative therapy (Radical prostatectomy or radiation) if cancer progresses.
* Tolerated previous transrectal ultrasound guided biopsy procedure under local anesthetic

  * Uncomplicated previous TRUS biopsy procedure (i.e., no prior hospitalization due to sepsis, prostatic abscess or severe hemorrhage following TRUS prostate biopsy)
* Willing to undergo the intratumoral (IT) injection of the Poly-ICLC into the prostatic tumor as per the protocol
* No prior hormonal therapy with exception of with the exception of oral 5-alpha-reductase inhibitors (finasteride, dutasteride, etc.). Subjects should be off the medication ≥ 6 months from screening
* No prior radiation therapy (external beam or brachytherapy) to the pelvis or prostate.
* No clinically significant infections as judged by the treating investigator.
* No characteristics suggesting a potential higher risk of infection with intraprostatic injections:

  * Recurrent urinary tract infections or history of prostatitis within 3 months prior to enrollment into the study.
  * Urine analysis positive for nitrites and leucocyte esterase. Such subjects could be considered for the study after treatment and resolution of the infection.
  * Active proctitis
  * History of prostatic abscess
  * Taking immunosuppressive medication including systemic corticosteroids
  * Active hematologic malignancy
* No uncontrolled angina, congestive heart failure or MI within 6 months.
* Subjects with history of HIV (if CD4+ T cell counts are ≥350 cells/μL on established ART therapy), Hepatitis B (with viral load below limits of quantification) or Hepatitis C (who have completed a curative therapy and have a viral load below the limit of quantification) are eligible for this study.
* No treatment with any investigational agent for any medical condition within 28 days prior to being registered for protocol therapy.
* Patients with the potential for impregnating their partner must agree to follow acceptable birth control methods to avoid conception. Contraception must be continued for at least 2 months following the last dose of poly-ICLC. While animal reproductive studies have been negative, the simulated viral infection and anti-proliferative activity of this experimental drug may theoretically affect the developing fetus or nursing infant.
* Adequate end organ function as determined by the following laboratory values:

  * White blood cell count (WBC) ≥ 2.5 k/mm\^3
  * Absolute neutrophil count (ANC) ≥ 1.5 k/mm\^3
  * Hemoglobin (Hgb) ≥ 8.0 g/dL
  * Platelets ≥ 100 k/mm\^3
  * Calculated creatinine clearance of \> 60 cc/min using the Cockcroft-Gault formula:
  * Males: \[(140 - Age in years) × Actual Body Weight in kg\]/\[72 × Serum Creatinine (mg/dL)\]
  * Bilirubin ≤ 2.0 x ULN
  * Aspartate aminotransferase (AST) ≤ 2.5 x ULN
  * Alanine aminotransferase (ALT) ≤ 2.5 x ULN

Exclusion Criteria:

* Received local or systemic curative therapy for prostate cancer
* Subjects with neuroendocrine tumors
* ISUP Gleason Grade Group (\>3), or Gleason 3+3 plus PSA ≤ 10 or Stage ≤T2a
* Evidence of locally advanced disease
* Subject has evidence of any other malignancy
* Allergy to any antibiotics, as IT administration requires prophylactic antibiotics.