Metastatic castrate-resistant prostate cancer (mCRPC) is a rapidly fatal end-sequelae of prostate cancer. The recent development of chimeric antigen receptor T-cell (CAR-T) therapy has revolutionised the treatment of treatment-resistant haematological malignancies, and several studies are underway investigating the utility of this technology in the treatment of solid tumours. In this review, we evaluate the current treatment options for men with mCRPC as well as the current landscape of preclinical and clinical trials of CAR-T cell therapy against prostate cancer.

A comprehensive literature search was conducted across multiple databases, including PubMed, EMBASE, Web of Science, and Cochrane. All clinical and pre-clinical trials were included in this narrative review. Additionally, an extensive examination of the United States National Library of Medicine clinical trials database was performed to provide a holistic overview of CAR-T trials underway.

Several tumour-associated antigens have been investigated including Prostate stem cell antigen (PSCA), Prostate specific membrane antigen (PSMA) & Epithelial Cell Adhesion Molecule (EpCAM). Preclinical trials have demonstrated promising results with marked tumour regression and even complete tumour eradication. However, this has not been recapitulated in humans to date.

The promising results of CAR-T cell therapy against a variety of prostate cancer specific tumour associated antigens have been limited to preclinical studies. Clinical trials have shown clinical safety and tolerability but poor efficacy.