Isaac Kim, MD, discusses the future of immunotherapy in prostate cancer

In the following video, Isaac Y. Kim, MD, PhD, MBA, reflects on the future of prostate cancer care and the themes explored in his recent editorial on how advances in detection and treatment may contribute to declining prostate cancer mortality rates by 2050.¹ Kim is the chair of the Department of Urology at Yale School of Medicine in New Haven, Connecticut.

Kim emphasized that predicting the next major therapeutic breakthrough remains speculative, but he identified immunotherapy as the area most likely to drive meaningful survival gains over the coming decades. Although immunotherapy has transformed the treatment of many solid and hematologic malignancies, prostate cancer has largely remained resistant to these approaches, leading to its characterization as an “immune-cold” tumor. Despite these challenges, Kim expressed optimism that a deeper understanding of prostate cancer biology will ultimately reveal ways to overcome this resistance.

According to Kim, one of the key unanswered questions is why prostate tumors fail to generate robust immune responses despite being composed of abnormal cells that should, in theory, be recognized by the immune system. He noted that ongoing advances in immunology are helping researchers better understand the factors that activate—or suppress—immune responses against cancer. As knowledge of these mechanisms expands, investigators may be able to refine immunotherapeutic strategies and identify approaches that are more effective in prostate cancer.

Kim also highlighted the importance of studying the interaction between androgens and immune cells, an area he believes has been relatively underexplored. He explained that because prostate cancer development and progression are fundamentally driven by androgens, understanding how hormones influence macrophages, T cells, and other immune effector cells could provide important insights into treatment resistance. Looking ahead, Kim said he expects researchers to continue unraveling the biological reasons behind prostate cancer’s limited responsiveness to immunotherapy, potentially paving the way for more effective immune-based treatments in the future.

REFERENCE

1. Brutus NN, Rabil MJ, Kim IY. Prostate cancer deaths will decrease by 2050. Urol Oncol. 2026;44(3):110971. doi:10.1016/j.urolonc.2025.12.007