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Pembrolizumab in mCRPC - Combination therapies as breakthrough to success?

Stefan Plas1, Andreas Pircher2, Isabel Heidegger1

  • 1Medical University of Innsbruck, Department of Urology.

Current Opinion in Urology
|August 21, 2023
PubMed
Abstract

Insights

Immune checkpoint inhibitors (ICIs) show promise in prostate cancer. Novel combination therapies with pembrolizumab may improve survival for metastatic castration-resistant prostate cancer (mCRPC) patients.

Area of Science:

  • Oncology
  • Immunotherapy
  • Prostate Cancer Research

Background:

  • Immune checkpoint inhibitors (ICIs) demonstrate antitumor potential in various cancers.
  • Pembrolizumab, a programmed death receptor 1 (PD-1) inhibitor, is FDA-approved and under investigation for metastatic castration-resistant prostate cancer (mCRPC).

Approach:

  • This review updates ongoing clinical studies of pembrolizumab in mCRPC, including monotherapy and combination strategies.
  • Investigational approaches combine pembrolizumab with approved mCRPC agents, radioligands, DNA vaccines, and novel immunotherapeutics (e.g., ONC-392, AMG160, BXCL701).

Key Points:

  • While many pembrolizumab trials did not meet primary endpoints, specific patient subgroups show significant responses.
  • ICI monotherapy is effective in a select, biomarker-identified population.
  • Emerging combination strategies involving pembrolizumab show promising preliminary results.

Conclusions:

  • Novel ICI combination approaches, particularly with pembrolizumab, hold potential to enhance patient survival in mCRPC.
  • These innovative strategies could significantly advance and transform mCRPC treatment paradigms.

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