Tang Yaxiong, Yi Xianyanling, Ai Jianzhong
Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 88 South Keyuan Road, Chengdu 610041, China.
Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 88 South Keyuan Road, Chengdu 610041, China.
Biochim Biophys Acta Rev Cancer. 2025 Jul;1880(3):189333. doi: 10.1016/j.bbcan.2025.189333. Epub 2025 Apr 25.
The treatment of advanced prostate cancer (PCa) primarily based on androgen deprivation therapy (ADT); however, patients inevitably progress to the castration-resistant prostate cancer (CRPC) stage. Despite the recent advancements in CRPC treatment with novel endocrine drugs that further inhibit androgen receptor signaling, resistance ultimately develops, underscoring the urgent need for new effective therapeutic strategies. Therapeutic cancer vaccines, a form of immunotherapy, exert anti-cancer effects by activating the host's immune system. Over the past few decades, various conventional therapeutic PCa vaccines based on cells, microbes, proteins, peptides, or DNA have been developed and tested in patients with advanced PCa. These attempts have largely failed to improve survival, with the sole exception of sipuleucel-T, which extended the median overall survival of asymptomatic or minimally symptomatic metastatic CRPC (mCRPC) patients by four months. The rapid development and high efficacy of mRNA vaccines during the COVID-19 pandemic have garnered worldwide attention. Compared to conventional vaccines, mRNA vaccines offer several unique advantages, including high production efficiency, low cost, high safety, strong immune response induction, and high adaptability and precision. These attributes make mRNA vaccines a promising frontier in the treatment of advanced PCa.
晚期前列腺癌(PCa)的治疗主要基于雄激素剥夺疗法(ADT);然而,患者不可避免地会进展到去势抵抗性前列腺癌(CRPC)阶段。尽管最近使用新型内分泌药物治疗CRPC取得了进展,这些药物进一步抑制雄激素受体信号传导,但最终仍会产生耐药性,这凸显了对新的有效治疗策略的迫切需求。治疗性癌症疫苗作为免疫疗法的一种形式,通过激活宿主免疫系统发挥抗癌作用。在过去几十年中,已经开发了各种基于细胞、微生物、蛋白质、肽或DNA的传统治疗性PCa疫苗,并在晚期PCa患者中进行了测试。这些尝试大多未能提高生存率,唯一的例外是sipuleucel-T,它将无症状或症状轻微的转移性CRPC(mCRPC)患者的中位总生存期延长了四个月。在2019年冠状病毒病(COVID-19)大流行期间,mRNA疫苗的快速发展和高效性引起了全球关注。与传统疫苗相比,mRNA疫苗具有几个独特的优势,包括高生产效率、低成本、高安全性、强免疫反应诱导能力以及高适应性和精准性。这些特性使mRNA疫苗成为晚期PCa治疗中一个有前景的前沿领域。