title: Immunotherapy in metastatic prostate cancer.
abstract: BACKGROUND
  Prostate cancer remains a challenge as a target for immunological approaches. The approval of the first cell-based immune therapy, Sipuleucel-T for prostate cancer introduced prostate cancer as a solid tumor with the potential to be influenced by the immune system.
  
  
  METHODS
  We reviewed articles on immunological management of prostate cancer and challenges that lie ahead for such strategies.
  
  
  RESULTS
  Treatments have focused on the identification of novel cell surface antigens thought to be unique to prostate cancer. These include vaccines against carbohydrate and blood group antigens, xenogeneic and naked DNA vaccines, and pox viruses used as prime-boost or checkpoint inhibitors. No single vaccine construct to date has resulted in a dramatic antitumor effect. The checkpoint inhibitor, anti-CTLA-4 has resulted in several long-term remissions, but phase III trials have not demonstrated an antitumor effect or survival benefit.
  
  
  CONCLUSIONS
  Multiple clinical trials suggest that prostate cancer may not be optimally treated by single agent immune therapies and that combination with biologic agents, chemotherapies, or radiation may offer some enhancement of benefit.
authors.affiliation: Department of Medicine, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
authors.forename: Susan F
authors.initials: SF
authors.lastname: Slovin
keywords: Chimeric antigen receptors; Sipuleucel-T; T cells; immunotherapy; ipilimumab; prostate cancer