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Updated: Jul 7, 2026
A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
Published on: November 7, 2025
Pitfalls or promise in prostate cancer immunotherapy-which is winning?
1Genitourinary Oncology Service, Sidney Kimmel Center for Prostate and Urologic Cancer, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. slovins@mskcc.org
Purpose:
Immunotherapy with vaccines, cytokines, and monoclonal antibodies against checkpoint molecules has been introduced into the clinical arena. Although all have demonstrated safety in clinical trials in patients with castrate metastatic prostate cancer, no one approach has been able to provide improved overall survival. This article is a review of the current issues and potential resolutions as to how we might go forward in developing and interpreting immunologic trials.
Design:
Phase I, II, and III trials showed that immunologic tolerance can be abrogated against specific tumor-associated antigens, but the immunologic readouts are suboptimal in determining whether a trial can go forward in its development.
Results:
Combinatorial approaches appear to be necessary for inducing immunogenicity and antitumor effects. Strategies include irradiated tumor cells lines, costimulatory molecules, or immune checkpoint inhibitors, which are in trials and are under intense scrutiny as to their impact on clinical end points such as time to disease progression and survival.
Discussion:
Strategies to enhance immunogenicity of vaccines and reassess how to effectively establish interpretable immunologic end points are under development and appear to be successful in affecting how these trials go forward.
Insights
Immunotherapy for prostate cancer shows safety but not improved survival. Combination strategies and better immune response measures are needed for future clinical trials in cancer immunotherapy.
Area of Science:
- Oncology
- Immunology
- Clinical Trials
Background:
- Immunotherapy, including vaccines, cytokines, and checkpoint inhibitors, is used for castrate metastatic prostate cancer.
- While safe, current immunotherapies have not improved overall survival in clinical trials.
Purpose of the Study:
- To review current challenges in developing and interpreting immunologic trials for prostate cancer.
- To explore potential resolutions for improving immunotherapy efficacy and trial design.
Main Methods:
- Review of Phase I, II, and III clinical trials involving various immunotherapy approaches.
- Analysis of immunologic tolerance, tumor-associated antigens, and immunologic readouts.
Main Results:
- Immunologic tolerance can be overcome, but current readouts are suboptimal for trial progression.
- Combinatorial approaches are necessary for inducing immunogenicity and antitumor effects.
- Strategies like irradiated tumor cells, costimulatory molecules, and immune checkpoint inhibitors are under investigation.
Conclusions:
- Enhancing vaccine immunogenicity is crucial for effective cancer immunotherapy.
- Developing interpretable immunologic endpoints is essential for successful clinical trial interpretation and advancement.
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