Advancing Prostate Cancer Treatment: Innovations and Challenges in Immunotherapy.

Prostate cancer (PCa), a leading cause of cancer mortality in men, has experienced a paradigm shift with the rise of immunotherapy. This chapter examines the immunological landscape of PCa and highlights key immunotherapeutic approaches, including cancer vaccines, immune checkpoint inhibitors (ICIs), adoptive cell therapies, and cytokine-based treatments. Emerging innovations, such as oncolytic viruses, neoantigen-based therapies, and bispecific antibodies, are also examined. Challenges like the immunosuppressive tumor microenvironment (TME), limited predictive biomarkers, and immune-related adverse events (irAEs) are addressed, alongside promising combination strategies with androgen deprivation therapy (ADT), radiotherapy, and targeted therapies. Advances in biomarker discovery and artificial intelligence (AI) are emphasized for their role in optimizing personalized immunotherapy. This chapter underscores the need for equitable access to these advancements and concludes with a vision for integrating immunotherapy into standard care, offering durable and transformative outcomes for PCa patients.