De Santis M
Klinik für Urologie, Charité Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Deutschland.
Urology, Medical University of Vienna, Wien, Österreich.
Urologe A. 2018 Nov;57(11):1342-1345. doi: 10.1007/s00120-018-0790-4.
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.
与其他肿瘤类型相比，前列腺癌（PCA）似乎更像是一个免疫荒漠。值得注意的是，前列腺癌很少表现出丰富的免疫细胞和促免疫原性微环境。
PCA的免疫治疗是否有效以及哪些患者能从中受益。
本文对文献及近期会议数据进行了综述。
前列腺癌疫苗sipuleucel-T的初步结果非常有前景，在随机III期研究中显示出显著的总生存获益，并且该个体化疫苗获得了美国食品药品监督管理局（FDA）的批准。与其他肿瘤类型不同的是，这并非免疫治疗新时代的立即突破，而是仍为一个孤立案例且仅限于美国。最近，多项试验评估了免疫治疗药物，但未达到其初步终点。有趣的是，个别患者确实从中受益并实现了长期缓解。
基因组测序和新的生物标志物也为PCA的个体化免疫治疗开辟了一条新途径。正在进行的研究和临床试验正在探索哪些患者将从中受益的问题。
