Immunotherapy for the treatment of prostate cancer-a comeback?

Background. Prostate cancer (PCA) seems to be more of an immunologic desert than other tumor entities. It is striking that only rarely does prostate cancer show abundant immune cells and aproimmunogenic microenvironment. Objectives. Is immunotherapy in PCA effective and which patients can benefit. Materials and methods. A review of the literature and recent congress data are presented. Results. Preliminary results with sipuleucel-T for PCA cancer were very promising showing asignificant overall survival benefit in randomised phaseIII studies and the US Federal Drug Administration (FDA) approval for this individualised vaccine. Contrary to other tumor entities this was not the immediate breakthrough to anew therapeutic era of immunotherapy but remained anisolated case and restricted to the USA. More recently, several trials evaluated immunotherapeutic agents but missed their preliminary endpoints. Interestingly, individual patients did benefit and showed long-term remission. Conclusions. Genome sequencing and new biomarkers are also paving anovel pathway towards individualised immunotherapy for PCA. On-going research and clinical trials are exploring the question of which patients will benefit.