CAR-T cell therapy in treating advanced prostate cancer

Abstract

Prostate cancer (PCa), a common cancer among older men, poses unique issues due to its slow progression and limited therapeutic choices for advanced stages. Since standard medicines such as chemotherapy and radiation have limited efficacy, it is in urgent need to develop novel therapies. CAR-T cell treatment modifies patients' T cells to produce chimeric antigen receptors that target certain antigens expressed on cancer cells, thereby enhancing the immune system's ability to identify and eliminate malignant cells. Targets for CAR-T cell therapy in prostate cancer include PSCA, PSMA, and EpCAM. Numerous studies have been conducted on PSMA, which is overexpressed in PCa cells. CAR-T cells that target PSMA have shown encouraging results in preclinical and clinical trials. Similarly, PSCA and EpCAM are promising targets for CAR-T cell therapy, with continuing research focused on improving their efficacy and safety profiles. The evolution of CAR-T cell therapy, spanning multiple generations, reflects continual efforts to enhance therapeutic outcomes. From first-generation CAR-T cells lacking co-stimulatory signals to advanced fourth and fifth-generation CAR-T cells equipped with additional functionalities like cytokine secretion, each iteration represents a progression towards improved efficacy and safety. However, optimizing CAR-T cell design, managing side effects, and identifying appropriate antigen targets still need to be addressed to realize the full promise of CAR-T cell therapy in PCa treatment. This review introduces the mechanisms, structures, evolution, and uses of CAR-T cell therapy in the treatment of PCa and discusses its great potential as a transformative cancer treatment strategy.