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Immune Checkpoint Inhibitors in Advanced Prostate Cancer: Current Data and Future Perspectives

Sara Elena Rebuzzi1,2, Pasquale Rescigno3, Fabio Catalano4

  • 1Medical Oncology Unit, Ospedale San Paolo, 17100 Savona, Italy.

Cancers
|March 10, 2022
PubMed

Insights

Immunotherapy shows limited success as a monotherapy for advanced prostate cancer (PCa). Combined strategies and biomarker-selected patients, particularly those with specific genetic alterations, offer promising avenues for improving treatment outcomes in PCa.

Area of Science:

  • Oncology
  • Immunology
  • Genetics

Background:

  • Advanced prostate cancer (PCa) remains incurable despite new therapies extending survival.
  • Immune checkpoint inhibitors (ICIs) have shown disappointing results as monotherapy in PCa clinical trials.
  • Understanding PCa immunobiology is crucial for developing effective immunotherapy strategies.

Purpose of the Study:

  • To discuss the immunobiology of prostate cancer (PCa).
  • To review ongoing trials and clinical data for immunotherapies in advanced PCa.
  • To identify patient subsets most likely to benefit from immunotherapy and explore new therapeutic targets.

Main Methods:

  • Review of current literature on prostate cancer (PCa) immunobiology and immunotherapy trials.
  • Analysis of clinical data regarding the efficacy of immune checkpoint inhibitors (ICIs) in PCa.
  • Evaluation of potential immunotherapy biomarkers and novel therapeutic targets.

Main Results:

  • Immune checkpoint inhibitor (ICI) monotherapy has shown modest efficacy in advanced prostate cancer (PCa).
  • Combined strategies involving ICIs with hormonal agents, chemotherapy, PARP inhibitors, radium-223, or TKIs demonstrate some positive results.
  • Tumor microenvironment evaluation requires qualitative assessment alongside genomic determinants.

Conclusions:

  • Immunotherapy in advanced prostate cancer (PCa) warrants further investigation, particularly in biomarker-selected patients.
  • Patients with specific pathway aberrations (e.g., AR-V7, HRD, CDK12-inactivated, MSI-high tumors) may benefit more from immunotherapy.
  • Exploring novel targets to modulate the tumor microenvironment could enhance antitumor activity with ICIs in PCa.
Keywords:
castration-resistantcastration-sensitiveimmune checkpoint inhibitorimmunotherapymolecular oncologypredictive biomarkersprognostic biomarkersprostate cancertumor microenvironment

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