Prostate cancer (PCA) seems to be more of an immunologic desert than other tumor entities. It is striking that only rarely does prostate cancer show abundant immune cells and a proimmunogenic microenvironment.
Is immunotherapy in PCA effective and which patients can benefit.
A review of the literature and recent congress data are presented.
Preliminary results with sipuleucel-T for PCA cancer were very promising showing a significant overall survival benefit in randomised phase III studies and the US Federal Drug Administration (FDA) approval for this individualised vaccine. Contrary to other tumor entities this was not the immediate breakthrough to a new therapeutic era of immunotherapy but remained an isolated case and restricted to the USA. More recently, several trials evaluated immunotherapeutic agents but missed their preliminary endpoints. Interestingly, individual patients did benefit and showed long-term remission.
Genome sequencing and new biomarkers are also paving a novel pathway towards individualised immunotherapy for PCA. On-going research and clinical trials are exploring the question of which patients will benefit.
Der Urologe. Ausg. A. 2018 Oct 19 [Epub ahead of print]
M De Santis
Klinik für Urologie, Charité Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Deutschland. .