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前列腺癌的免疫治疗策略:综合综述

英文原题:Immunotherapeutic Strategies for Prostate Cancer: A Comprehensive Review.

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Immunotherapeutic Strategies for Prostate Cancer: A Comprehensive Review.

PubMed 2026/01/14(内容时间) Cancers (Basel) Q2 · IF 4.8(JCR 2025)

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中文摘要

前列腺癌(PCa)是全球癌症相关死亡的首要原因,也是男性中第二常见癌症。治疗选择取决于年龄、雄激素敏感性、PSA水平、Gleason评分、TNM分期和复发风险等因素。现有治疗包括激素治疗、放疗、手术和化疗。早期免疫治疗受淋巴细胞浸润不足和免疫抑制性环境限制。如今,树突状细胞疫苗、免疫检查点抑制剂(ICI)和过继细胞治疗(ACT)等策略已投入使用。ACT,尤其是CAR-T 细胞策略,旨在克服传统治疗的局限,重点面向晚期及转移性去势抵抗性前列腺癌(mCRPC),但仍处于早期开发阶段。个体化医疗利用患病组织的分子信息制定定制治疗。由于肿瘤异质性和既往治疗不同,患者应答存在差异,这凸显个体化治疗和联合治疗作为未来有效免疫治疗策略的重要性。本综述考察PCa当前治疗格局,分析NCCN和EANM-ESTRO-ESUR-ISUP-SIOG制定的治疗指南,并全面讨论已用于或正在研究的前列腺癌免疫治疗策略,重点涉及ICI、以CAR-T 为主的ACT、联合策略及治疗协同作用,以及免疫治疗应答预测性生物标志物。文章还讨论前列腺癌管理中免疫治疗应用面临的挑战和未来方向。

展开英文摘要原文

Prostate cancer (PCa) is the leading cause of cancer-related deaths worldwide and the second most common cancer among men. Treatment options depend on factors like age, androgen sensitivity, PSA levels, Gleason score, TNM stage, and recurrence risk. Available treatments include hormonal therapy, radiation, surgery, and chemotherapy. Early immunological treatments were limited by poor lymphocyte infiltration and an immunosuppressive environment. Today, strategies such as dendritic cell vaccines, immune checkpoint inhibitors (ICIs), and adoptive cell therapy (ACT) are used.

ACT, especially CAR T-cell strategies, aims to overcome traditional treatment limitations, particularly in advanced and metastatic castration-resistant prostate cancer (mCRPC), though it remains in early development. Personalized medicine uses molecular insights from the diseased tissue to tailor treatments.

Variability in patient response, due to tumor heterogeneity and prior treatments, highlights the importance of personalized and combination therapies as future strategies for effective immunotherapy. This review explores the current landscape of PCa.

We analyze treatment guidelines established by NCCN and EANM-ESTRO-ESUR-ISUP-SIOG.

We comprehensively examine immunotherapeutic strategies currently available or under investigation for prostate cancer, with particular emphasis on ICIs, ACT with a focus on CAR T-cell therapy, combination approaches and therapeutic synergies, and predictive biomarkers of immunotherapy response.

Additionally, we discuss the challenges and future directions in the implementation of immunotherapy for the management of prostate cancer.

论文信息

作者
Flores-Islas AK、Rico-Fuentes C、Sierra-Díaz E、García-Chagollán M、Pereira-Suárez AL、Zepeda-Nuño JS、Moreno-Ortiz JM、Ramírez-de-Arellano A
单位
Instituto de Investigación en Cáncer e Infecciones, Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico.Mexico
文献类型
综述
期刊
Cancers2026 Jan 14
原文标识
PubMed 41595174 · DOI 10.3390/cancers18020255