Department of Urology, Medical University Innsbruck, Innsbruck, Austria.
Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Eur Urol Oncol. 2021 Oct;4(5):745-754. doi: 10.1016/j.euo.2020.10.010. Epub 2020 Nov 23.
The role of immune checkpoint inhibition (ICI) in the treatment of prostate cancer (PC) still remains elusive. It has been proposed that combination of ICI with other molecules increases the efficacy of immunotherapy in PC.
To systematically review the literature to assess the potential role of ICI in combination with additional therapies for the management of metastatic castration-resistant PC (mCRPC).
A systematic review using Medline and scientific meeting records was carried out in September 2020 according to the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines. Ongoing trials of immunotherapy with standard mCRPC therapeutics were identified via a systematic search on ClinicalTrials.gov.
A total of five full-text papers, ten congress abstracts, and 15 trials on ClinicalTrials.gov were identified. Preclinical evidence suggests that combinational approaches might be considered to enhance the efficacy of ICI in PC patients. This led to the design of more than 50 immunotherapy-based clinical trials. The majority of the studies focus on ICI combinations with vaccines, androgen deprivation therapy, chemotherapy, PARP inhibition, radiotherapy, and prostate-specific membrane antigen-guided radioligand therapy. Preliminary analyses reported promising findings for the use of ICI in combination with other anticancer therapies. However, no phase 3 trial has yet reported final results, so no level 1 evidence with long-term outcomes currently supports the combination of ICI with mCRPC therapies.
Preclinical and clinical trials have demonstrated that combining immunotherapy with standard mCRPC treatment options has the potential to provide a synergistic effect. Nonetheless, a better understanding of the mechanism and of the optimal treatment approach is still needed.
We reviewed the literature on immunotherapy in combination with standard treatments for patients with metastatic castration-resistant prostate cancer (mCRPC). Current evidence supports the hypothesis that immunotherapeutic drugs might be effective in mCRPC if combined with other treatment options. However, results of ongoing trials are still awaited before this novel treatment approach can be implemented in the daily practice.
免疫检查点抑制（ICI）在前列腺癌（PC）治疗中的作用仍不明确。有人提出，ICI 与其他分子联合使用可以提高 PC 免疫治疗的疗效。
系统综述文献，评估 ICI 联合其他疗法治疗转移性去势抵抗性前列腺癌（mCRPC）的潜在作用。
根据系统评价和荟萃分析的首选报告项目指南，于 2020 年 9 月使用 Medline 和科学会议记录进行了系统综述。通过在 ClinicalTrials.gov 上进行系统搜索，确定了正在进行的免疫治疗联合标准 mCRPC 治疗的试验。
共确定了五篇全文论文、十篇大会摘要和 15 项 ClinicalTrials.gov 试验。临床前证据表明，联合治疗方法可能被认为可以增强 ICI 在 PC 患者中的疗效。这导致了 50 多项基于免疫疗法的临床试验的设计。大多数研究侧重于 ICI 与疫苗、去势治疗、化疗、PARP 抑制、放疗和前列腺特异性膜抗原指导的放射性配体治疗的联合。初步分析报告了 ICI 联合其他抗癌疗法的有希望的结果。然而，目前尚无 III 期试验报告最终结果，因此，没有长期结果的 1 级证据支持 ICI 与 mCRPC 治疗联合使用。
临床前和临床试验表明，将免疫疗法与标准 mCRPC 治疗选择相结合具有协同作用的潜力。尽管如此，仍然需要更好地了解其作用机制和最佳治疗方法。
我们回顾了免疫疗法联合标准治疗转移性去势抵抗性前列腺癌（mCRPC）患者的文献。目前的证据支持这样一种假设，即免疫治疗药物如果与其他治疗选择联合使用，可能对 mCRPC 有效。然而，在这种新的治疗方法能够在日常实践中实施之前，仍需等待正在进行的试验的结果。
