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Passive-specific immunotherapy with monoclonal antibodies for prostate cancer: A systematic review
Neda Khalili1,2, Mahsa Keshavarz-Fathi2,3,4, Sepideh Shahkarami5,6
11 Border of Immune Tolerance Education and Research Network (BITERN), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Introduction:
Treatment of metastatic castration-resistant prostate cancer with conventional therapies is still not successful. Therefore, application of novel biological approaches such as immunotherapy, which appears to be more effective and less toxic, is necessary. Monoclonal antibodies against cancer specific antigens are a kind of immunotherapy that have been approved for specific types of cancer and are being investigated for prostate cancer as well. The aim of this review was to assess the effectiveness and safety of monoclonal antibodies for treatment of advanced prostate cancer.
Method:
According to the search strategy stated in our systematic review protocol, Scopus, Medline, TRIP, CENTRAL, ProQuest, DART and OpenGrey databases were searched. Data collection and quality assessment were done independently by two authors and any disagreements between the collected data were resolved by a third author. A meta-analysis was not feasible as there was a considerable statistical heterogeneity among the trials. Hence, this review was limited to a narrative analysis of the included studies.
Results:
We found 9756 references by applying search strategy in 4 databases of journal articles and 3 databases of grey literature. We then discarded 3957 duplicate citations using Endnote software and 5143 articles due to obvious irrelevancy of their topics in primary screening. In secondary screening of 656 fulltexts, we excluded 538 articles, and finally included 12 trials in this systematic review, updated on 23 June 2017. The overall quality of the studies was fair. In general, results of this systematic review show promising advances in the treatment of prostate cancer patients with monoclonal antibodies against prostate-specific antigens with regard to PSA/disease response. Some of the studies reported pain relief after treatment as well.
Conclusion:
Currently, the role of immunotherapy in the treatment of advanced prostate cancer still remains debated. Although passive specific immunotherapy could be offered as a novel therapeutic option in the coming years, patients should be informed about the risks and benefits of this therapy. One of the obstacles in this review was the lack of adequate assessment of survival-related endpoints reported in the included studies. Our study provides support for further research in this field.
Insights
Monoclonal antibodies show promise for treating advanced prostate cancer, with some studies reporting improved PSA/disease response and pain relief. Further research is needed to fully understand their role and survival benefits.
Area of Science:
- Oncology
- Immunotherapy
- Prostate Cancer Research
Background:
- Conventional therapies for metastatic castration-resistant prostate cancer often lack efficacy.
- Immunotherapy, particularly monoclonal antibodies targeting cancer-specific antigens, presents a less toxic and potentially more effective alternative.
- Monoclonal antibodies are approved for certain cancers and are under investigation for prostate cancer.
Purpose of the Study:
- To systematically review the effectiveness and safety of monoclonal antibodies in treating advanced prostate cancer.
- To assess the current evidence for monoclonal antibody therapy in prostate cancer management.
Main Methods:
- A systematic literature search was conducted across multiple databases (Scopus, Medline, TRIP, CENTRAL, ProQuest, DART, OpenGrey).
- Data collection and quality assessment were performed independently by two authors, with disagreements resolved by a third.
- Due to statistical heterogeneity, a narrative analysis was conducted instead of a meta-analysis.
Main Results:
- 12 trials were included in the systematic review after extensive screening of 9756 initial references.
- The included studies, of fair overall quality, indicated promising advances in prostate cancer treatment using monoclonal antibodies targeting prostate-specific antigens.
- Positive outcomes included improvements in prostate-specific antigen (PSA)/disease response and, in some cases, pain relief.
Conclusions:
- The role of immunotherapy, specifically monoclonal antibodies, in advanced prostate cancer treatment remains under investigation.
- While passive specific immunotherapy may emerge as a future therapeutic option, comprehensive patient counseling on risks and benefits is crucial.
- A significant limitation was the inadequate reporting of survival-related endpoints, highlighting the need for further research in this area.
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