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Updated: Jul 30, 2025

A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
Metastatic Castration-Resistant Prostate Cancer, Immune Checkpoint Inhibitors, and Beyond
Sree M Lanka1, Nicholas A Zorko2, Emmanuel S Antonarakis2
1Deming Department of Medicine, Tulane University, New Orleans, LA 70112, USA.
Abstract:
The therapeutic landscape of several genitourinary malignancies has been revolutionized by the development of immune checkpoint inhibitors (ICIs); however, the utility of immunotherapies in prostate cancer has been limited, partly due to the immunologically "cold" tumor terrain of prostate cancer. As of today, pembrolizumab is the only immune checkpoint inhibitor approved for the treatment of metastatic castration resistant prostate cancer (mCRPC) in a select group of patients with high microsatellite instability (MSI-H), deficient mismatch repair (dMMR), or high tumor mutational burden (TMB). Looking ahead, several combinatorial approaches with ICIs involving radioligands, radiotherapy, PARP inhibitors, interleukin inhibitors, and cancer vaccines are exploring a potential synergistic effect. Furthermore, B7-H3 is an alternative checkpoint that may hold promise in adding to the treatment landscape of mCRPC. This review aims to summarize previous monotherapy and combination therapy trials of ICIs as well as novel immunotherapy combination therapeutic strategies and treatment targets in mCRPC.
Insights
Immune checkpoint inhibitors show limited success in prostate cancer due to its "cold" tumor environment. Research is exploring combination therapies and novel targets like B7-H3 to improve treatment for metastatic castration-resistant prostate cancer.
Area of Science:
- Oncology
- Immunotherapy
- Genitourinary Malignancies
Background:
- Immune checkpoint inhibitors (ICIs) have transformed genitourinary cancer treatment.
- Prostate cancer's immunologically "cold" nature limits immunotherapy efficacy.
- Pembrolizumab is approved for select metastatic castration-resistant prostate cancer (mCRPC) patients with MSI-H/dMMR or TMB-H.
Purpose of the Study:
- To review current ICI monotherapy and combination trials in mCRPC.
- To explore novel immunotherapy strategies and targets for mCRPC.
- To summarize the therapeutic landscape of immunotherapies in prostate cancer.
Main Methods:
- Literature review of clinical trials involving ICIs in mCRPC.
- Analysis of ongoing and planned combination therapy studies.
- Examination of emerging immunotherapy targets, including B7-H3.
Main Results:
- Limited efficacy of current ICI monotherapy in prostate cancer.
- Promising results from ongoing combination trials (e.g., with radioligands, PARP inhibitors).
- B7-H3 identified as a potential novel immunotherapy target.
Conclusions:
- Combinatorial approaches are crucial for enhancing ICI effectiveness in mCRPC.
- Targeting novel checkpoints like B7-H3 may expand treatment options.
- Further research into immunotherapy combinations is essential for advancing mCRPC treatment.
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