Introduction: Within the last decade, multiple innovative immune platforms have been developed and tested in patients with metastatic castration resistance prostate cancer (mCRPC) with only one demonstrating a survival benefit. The advent of immunogenomics along with the availability of diverse checkpoint inhibitors provides inroads in treating these patients, in many cases with significant clinical impact but unfortunately not in all patients. How to exploit these novel platforms remains an area of increased interest especially in the setting of new agents that can affect the tumor microenvironment and potentially render a "cold" tumor to become "hot".Arevs Covered: This review highlights the current changes and challenges in this field and how to best use our current knowledge for better trial designs in patients with mCRPC.Expert Opinion: Recent understanding of the inhibitory milieu within the tumor microenvironment has fostered the use of combinatorial strategies that target not only tumor cells but capitalize on controlling inhibitory cell populations and cytokines that induce a hostile setting for immune cells. Immunogenomics and genomic interrogation of prostate cancers have opened a vista as to how patients' tumors that can respond to immune agents that previously were thought have minimal antitumor activity.

中文翻译：

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去势抵抗性前列腺癌的免疫疗法：时机已到？

简介：在过去十年中，已经开发出多种创新的免疫平台，并在转移性去势抵抗性前列腺癌 (mCRPC) 患者中进行了测试，其中只有一种证明了生存获益。免疫基因组学的出现以及多种检查点抑制剂的可用性为治疗这些患者提供了进展，在许多情况下具有显着的临床影响，但不幸的是并非对所有患者都有效。如何利用这些新平台仍然是一个越来越受关注的领域，特别是在设置可能影响肿瘤微环境并可能使“冷”肿瘤变得“热”的新药物方面。Arevs Covered：这篇综述强调了当前的变化和挑战在这个领域，以及如何最好地利用我们目前的知识来更好地设计 mCRPC 患者的试验。专家意见：最近对肿瘤微环境中抑制性环境的了解促进了组合策略的使用，这些策略不仅针对肿瘤细胞，而且利用控制抑制性细胞群和细胞因子来诱导免疫细胞的敌对环境。前列腺癌的免疫基因组学和基因组研究为患者的肿瘤如何对以前被认为具有最小抗肿瘤活性的免疫剂作出反应开辟了前景。