去势抵抗性前列腺癌免疫治疗新进展

New propress of castration-resistant prostate cancer immunotherapy

前列腺癌已成为危害我国男性人群健康的严重问题,尤其是去势抵抗性前列腺癌（CRPC）,预后极差,治疗棘手,亟需寻找新的治疗手段.近年的研究结果表明,前列腺癌细胞能够刺激免疫应答,因此,免疫治疗成为CRPC治疗的研究热点之一.多肽疫苗、核酸疫苗、全细胞疫苗和自体树突状细胞疫苗等肿瘤疫苗的研究多已处于二、三期临床试验阶段,具有良好的应用前景;免疫检查点抑制剂用于治疗黑色素瘤等疾病效果满意,但用于CRPC尚缺乏系统研究,疗效仍需观察;免疫调节剂对CRPC虽然显示出抗肿瘤活性,但患者总体生存时间并未得到延长.现有研究结果显示CRPC免疫治疗的前景良好,但多数药物仍处于前临床研究阶段,与真正的临床应用尚存在相当距离,免疫治疗的最佳介入时机、联合用药的价值、治疗效果的评估、预测性和预后性免疫标志物的建立等问题均有待探索.相信随着肿瘤免疫制剂的开发和循证医学证据的积累,CRPC的免疫治疗将获得更规范的应用.

Prostate cancer,especially castration-resistant prostate cancer （CRPC） with its very poor prognosis,quite difficult treatments and urgent need of new theraputic strategies has become a serious problem of men＆#39;s health in our country.Recent studies have shown that prostate cancer cells can stimulate the immune response;therefore,immunotherapy has become one of the hot spots in the treatment of CRPC.Cancer vaccines including polypeptide vaccines,nucleic acid vaccines,whole cell vaccines and autologous dendritic cell vaccines have been in stage Ⅱ or Ⅲ clinical trials,and will have good application prospects.Immune checkpoint inhibitors for the treatment of melanoma have got satisfactory results,but for CRPC are lack of systematic researches and the effects remain to be followed-up.Immune modulators for CRPC have shown antitumor activity,but the overall survival of patients was not improved.Existing studies have shown that immunotherapy of CRPC has good prospects,but most drugs are still in the research stage and need a considerable distance before clinical application.The optimal timing of immunotherapy,value of combined administration,evaluation of therapeutic effect,potential immune-based predictive and prognostic biomarkers are to be explored.With the development of tumor immune agents and the accumulation of evidence based medicine,CRPC immunotherapy will be more standard.