How to cite: Slovin SF. “Immunotherapy When Nothing Else Works: Rational or Irrational Approach?” Grand Rounds in Urology. August 2026. Accessed Oct 2026. https://grandroundsinurology.com/immunotherapy-when-nothing-else-works-rational-or-irrational-approach/
Summary
In this presentation from the UroCancer Interdisciplinary Forum (UCIF) 2026, Susan F. Slovin, MD, PhD, Genitourinary Oncologist, Memorial Sloan Kettering Cancer Center, New York, New York, examines whether immunotherapy remains a rational treatment option for patients with advanced prostate cancer who have exhausted conventional therapies. She emphasizes that immunotherapy extends well beyond immune checkpoint inhibitors and includes vaccines, antibody-drug conjugates, bispecific T-cell engagers, chimeric antigen receptor (CAR) T-cell therapies, and other cellular platforms.
Dr. Slovin presents the case of a 73-year-old man with metastatic castration-resistant prostate cancer who experienced disease progression after more than two decades of treatment, including androgen receptor pathway inhibitors, chemotherapy, poly (ADP-ribose) polymerase (PARP) inhibitors, radioligand therapy, stereotactic radiotherapy, and multiple investigational approaches. With no remaining standard treatment options, she discusses the limitations of empiric checkpoint inhibitor therapy in biomarker-negative disease and the need for more rational immunotherapeutic strategies.
She reviews the evolving landscape of prostate cancer immunotherapy, highlighting novel therapeutic targets, including STEAP1, STEAP2, KLK2, B7-H3, PSMA, Trop-2, and other cell-surface antigens. Dr. Slovin explains how CAR T-cell therapies and bispecific T-cell engagers are being engineered to overcome the immunosuppressive tumor microenvironment, improve specificity, and reduce toxicity.
The featured patient achieved a substantial biochemical, radiographic, and pathologic response following treatment with autologous STEAP2-directed CAR T cells. Dr. Slovin emphasizes that this case demonstrates that immunotherapy can produce meaningful clinical responses in selected patients. She argues that prostate cancer presents a heterogeneous immune landscape rather than a uniformly “cold” tumor, with future success hinging on biomarker-driven patient selection, optimized therapeutic platforms, earlier intervention, and a better understanding of the tumor microenvironment.
ABOUT THE AUTHOR
Susan F. Slovin, MD, PhD is a Genitourinary Medical Oncologist and Cellular Therapist, and the Associate Vice Chair of Academic Affairs for the Department of Medicine for the Memorial Sloan Kettering Cancer Institute in New York City, New York. Dr. Slovin specializes in prostate cancer, genitourinary cancers, cellular therapy, and clinical trials. Her clinical expertise is in clinical immunology, other genitourinary malignancies, internal medicine, and medical oncology.
Dr. Slovin earned her medical degree from Jefferson Medical College in Philadelphia, Pennsylvania. She completed a residency in Internal Medicine at Mount Sinai Hospital in New York, New York. Dr. Slovin then completed a fellowship in Clinical Immunology at Scripps Clinic & Research Foundation in La Jolla, California. She completed a fellowship in Medical Oncology/Hematology at Memorial Sloan Kettering Cancer Center in New York, New York. Dr. Slovin then completed a fellowship in Medicine at Weill Cornell Medical College in [New York, New York.
Dr. Slovin has won numerous awards in recognition for her contributions to the field, including America’s Top Doctor (2025, 2024, 2023), Exceptional Women in Medicine (2024, 2023), and the Top Doctor New York Metro Area (2023). She has published 222 articles and book chapters in her field and has been featured in the Journal of Clinical Oncology, European Urology Oncology, and the Journal of Immunotherapy and Precision Oncology.
