Reprogramming the immune response in prostate cancer treatment

Prostate cancer is the most common malignant disease among men, accounting for approximately 29% of all cancer cases in males. Recent research in the prostate cancer treatment has shown that immunotherapy can significantly improve the quality of treatment, extend remission, and enhance patient survival. However, the tumor microenvironment can negatively affect the efficacy of immunotherapy. Insufficient T-cell infiltration, immunosuppressive microenvironment, tumor-associated T and B lymphocytes, macrophages, and myeloid-derived suppressor cells substantially reduce the efficacy of immunotherapy. Current immunotherapy strategies include vaccine-based approaches, immune checkpoint inhibitors, CAR T-cell therapy, T-cell activators, etc. This review highlights the key therapeutic approaches aimed at reprogramming the immune response in prostate cancer, including nucleic acid-based vaccines, peptide-based vaccines, viral vector-based vaccines, immune cell-based vaccines, checkpoint inhibitors, CAR T-cell therapy, and bispecific antibodies. It also presents clinical and preclinical data on these therapies. Current immunotherapy approaches demonstrate significant potential in activating and directing the immune response against tumor cells. However, further research is required to better understand the underlying mechanisms and to develop new therapeutic strategies.