Prostate cancer (PCa) is the leading cause of cancer-related deaths worldwide and the second most common cancer among men. Treatment options depend on factors like age, androgen sensitivity, PSA levels, Gleason score, TNM stage, and recurrence risk. Available treatments include hormonal therapy, radiation, surgery, and chemotherapy. Early immunological treatments were limited by poor lymphocyte infiltration and an immunosuppressive environment. Today, strategies such as dendritic cell vaccines, immune checkpoint inhibitors (ICIs), and adoptive cell therapy (ACT) are used. ACT, especially CAR T-cell strategies, aims to overcome traditional treatment limitations, particularly in advanced and metastatic castration-resistant prostate cancer (mCRPC), though it remains in early development. Personalized medicine uses molecular insights from the diseased tissue to tailor treatments. Variability in patient response, due to tumor heterogeneity and prior treatments, highlights the importance of personalized and combination therapies as future strategies for effective immunotherapy. This review explores the current landscape of PCa. We analyze treatment guidelines established by NCCN and EANM-ESTRO-ESUR-ISUP-SIOG. We comprehensively examine immunotherapeutic strategies currently available or under investigation for prostate cancer, with particular emphasis on ICIs, ACT with a focus on CAR T-cell therapy, combination approaches and therapeutic synergies, and predictive biomarkers of immunotherapy response. Additionally, we discuss the challenges and future directions in the implementation of immunotherapy for the management of prostate cancer.
前列腺癌（PCa）是全球癌症相关死亡的主要原因，也是男性中第二常见的癌症。治疗方案的选择取决于年龄、雄激素敏感性、PSA水平、Gleason评分、TNM分期及复发风险等因素。现有治疗手段包括激素治疗、放疗、手术和化疗。早期免疫治疗因淋巴细胞浸润不足和免疫抑制环境而受限。如今，树突状细胞疫苗、免疫检查点抑制剂（ICIs）和过继性细胞疗法（ACT）等策略已被应用。ACT，尤其是CAR T细胞策略，旨在克服传统治疗的局限，特别是在晚期和转移性去势抵抗性前列腺癌（mCRPC）中，尽管该领域仍处于早期发展阶段。个性化医疗通过分析病变组织的分子特征来定制治疗方案。由于肿瘤异质性和既往治疗差异导致的患者反应多样性，突显了个性化治疗与联合疗法作为未来有效免疫治疗策略的重要性。本综述探讨了前列腺癌的当前现状，分析了美国国家综合癌症网络（NCCN）及欧洲核医学协会-欧洲放射肿瘤学会-欧洲泌尿外科学会-国际泌尿病理学会-国际老年肿瘤学会（EANM-ESTRO-ESUR-ISUP-SIOG）制定的治疗指南。我们全面检视了当前已应用或正处于研究阶段的前列腺癌免疫治疗策略，重点关注免疫检查点抑制剂、以CAR T细胞疗法为核心的过继性细胞疗法、联合治疗策略与协同作用，以及免疫治疗反应的预测性生物标志物。此外，我们还讨论了前列腺癌免疫治疗实践中的挑战与未来发展方向。
Immunotherapeutic Strategies for Prostate Cancer: A Comprehensive Review
肿瘤(癌症)患者之家