Kwon Whi-An, Joung Jae Young
Department of Urology, Hanyang University College of Medicine, Myongji Hospital, Goyang 10475, Republic of Korea.
Department of Urology, Urological Cancer Center, National Cancer Center, Goyang 10408, Republic of Korea.
Cancers (Basel). 2025 Mar 21;17(7):1064. doi: 10.3390/cancers17071064.
Immunotherapy has shown limited efficacy in prostate cancer, largely due to low tumor immunogenicity, sparse tumor-infiltrating lymphocytes, and a suppressive microenvironment. Recent therapeutic strategies aim to boost immune responses and counteract immunosuppressive factors through interventions such as immune checkpoint inhibitors, immunogenic cell death-inducing therapies, and the targeted blockade of pathways like that of transforming growth factor-β. Vaccine-based approaches, potent immune adjuvants, and engineered chimeric antigen receptor (CAR) T cells are also being investigated to overcome local immune inhibitory signals. Advancements in imaging, multi-omic profiling, and liquid biopsies offer promising avenues for real-time monitoring, better patient selection, and precision treatment. This review provides an overview of the key immunosuppressive features of prostate cancer, current immunotherapeutic modalities, and emerging strategies to transform "cold" tumors into more responsive "hot" targets. By integrating these approaches, we may achieve more durable clinical benefits for patients with advanced or metastatic prostate cancer.
免疫疗法在前列腺癌中的疗效有限，这在很大程度上归因于肿瘤免疫原性低、肿瘤浸润淋巴细胞稀少以及存在抑制性微环境。最近的治疗策略旨在通过免疫检查点抑制剂、诱导免疫原性细胞死亡的疗法以及对转化生长因子-β等信号通路的靶向阻断等干预措施来增强免疫反应并对抗免疫抑制因子。基于疫苗的方法、强效免疫佐剂以及工程化嵌合抗原受体（CAR）T细胞也正在研究中，以克服局部免疫抑制信号。成像、多组学分析和液体活检方面的进展为实时监测、更好的患者选择和精准治疗提供了有前景的途径。本综述概述了前列腺癌的关键免疫抑制特征、当前的免疫治疗方式以及将“冷”肿瘤转化为更具反应性的“热”靶点的新兴策略。通过整合这些方法，我们可能为晚期或转移性前列腺癌患者带来更持久的临床益处。
