Immunotherapy in Prostate Cancer: Past, Current, and Future

免疫療法在攝護腺癌的進展：過去、現在、與未來

歐宴泉(Yen-Chuan Ou) ； 陳鴻霖(Hung-Lin Chen)

《童綜合醫學雜誌》 12卷1期 (2018/06) Pp. 1-5

摘要

Prostate cancer is one of the most prevalent cancers worldwide and is the fifth leading cause of deaths due to cancer in Taiwan. Reducing the morbidity and mortality of prostate cancer is a major concern for the Ministry of Health and Welfare of Taiwan. Immunotherapy has been the dominant field in oncology, particularly when checkpoint inhibitors become crucial factors in pharmaceutical industries. The progression of cancer immunotherapy has already achieved several milestones. However, exclusive characteristics of prostate cancer restrict the efficacy of immunotherapy. We reviewed recent clinical trials showing supporting and adverse outcomes of immunotherapy in metastatic castration-resistant prostate cancers, including cancer vaccines, checkpoint inhibitors, and adoptive T cells. To implement immunotherapy in prostate cancer, shaping an adequate microenvironment for the immune system is key. Although current outcomes of immunotherapy for prostate cancer have not been encouraging, these are expected in future.

關鍵字

Immunotherapy ； Checkpoint inhibitor ； CAR-T ； Prostate cancer

並列摘要

攝護腺癌是世界上普及率極高的癌症，也是台灣前十大癌症死因的第五名。如何降低攝護腺癌的發生率與死亡率是台灣衛生福利部的首要目標之一。免疫療法近期在癌症領域有許多傑出的臨床成效，促使免疫療法成為癌症治療領域中的焦點，尤其是免疫檢查點抑制劑已然是各大藥廠新藥發展的重要一環。但是因為攝護腺癌的先天特性讓免疫治療的療效並沒有達到預期的效果。本文中，我們回顧過往以及目前免疫療法在轉移性去勢抗性攝護腺癌的臨床試驗, 包含攝護腺癌疫苗、免疫檢查點抑制劑與嵌合抗原受體T 細胞療法。目前這些臨床試驗的結果正反兩面皆有，因此攝護腺癌是否適合免疫療法還在評估，尚未有確論。免疫療法若要在攝護腺癌有所突破，關鍵點在於改變攝護腺癌先天生理上的特性，塑造一個適合活化免疫系統的微型環境，改變微型環境需要組合式治療方案來達成。雖然現在單一免疫療法對於攝護腺癌的成效未振奮人心，但以組合式治療方案來改善適合免疫系統的微型環境，使得免疫療法在攝護腺癌治療上還有許多的未來發展性。

並列關鍵字

攝護腺癌 ； 免疫治療 ； 癌症疫苗 ； 免疫檢查點抑制劑 ； 嵌合抗原受體T細胞