Protein expression levels in immunohistochemistry and molecular biomarkers have been reported for their ability to predict recurrence, progression, development of metastases, and patient survival. The molecular features in low- and high-grade prostate cancer can differ and influence treatment decision and prognosis. The objective of the current study was to compare the expression of exosomal biomarkers CD63 and mismatch repair proteins (MSH2, MSH6, MLH1, and PMS2) by immunohistochemistry (IHC) in tissue of patients with prostate cancer and benign hyperplasia. Altogether, 62 patients with prostate acinar adenocarcinoma and 20 patients with prostate benign hyperplasia were enrolled in this retrospective study. CD63, MSH2, MSH6, MLH1, and PMS2 expression was analysed by immunohistochemistry. The obtained results showed that CD63 expression was significantly higher in patients with Grade III–V prostate cancer compared to Grade I–II, respectively; 2.23 (1–3) vs 0.92 (0–2) score, p = 0.001. In addition, a significant positive correlation between CD63 expression and grade groups was revealed (Rho = +0.54; p < 0.0001). Furthermore, progression-free survival was significantly higher in patients with low CD63 expression, compared to high CD63 expression (p = 0.0007). MMR expression was absent in 14 patients (four patients with Grade I–II cancer and 10 patients with Grade III–cancer). MMR was present in all cases of benign prostate hyperplasia (mild to moderate staining). The conclusion was that high grade prostate cancer (Grade groups III–V) was characterised by increased CD63 expression, which correlated with progression-free survival.

Early detection and diagnosis of cancer followed by a personalised approach to treatment is a key and can save lives. It has been an important issue in both the medical and social fields. The search for instruments and/or diagnostics tools able to detect cancers at an early stage has led to consideration of the usage of various approaches, such as exhaled air, biomarkers in blood, urine testing as well as imaging techniques. This actual time and everything that is happening around us could be characterised as a strange and very unpredictable time. This comparison could be made not only due to the actual coronavirus situation, but also the same can be noticed in the personalised medicine of the second decade of 21st century — by means of check point inhibitors. The old dogmas, for instance, chemotherapy and metastasis-surgery are being appended with new diagnostic and therapy use of checkpoint inhibitors. What exactly is the checkpoint blockade and how it is working in three tumour modalities: bladder cancer, prostate cancer and renal cancer. Our study group will provide a brief and detailed, guideline-compliant outline. The aim of this review was to provide a summary of the current state of the art of immune therapy as potential treatment of prostate, urinary bladder, and kidney cancer.

Treatment of advanced and metastatic prostate carcinoma (PCa) is still challenging and changing in the era of personalised medicine. Combination therapies with docetaxel and new anti-hormonal substances lead to improved OS (overall survival) in a broad group of patients with metastatic hormone sensitive prostate carcinoma (mHSPCa). Addition of docetaxel or an androgen receptor targeting agent (ARTA) with abiraterone plus prednisolone, with apalutamide or with enzalutamide leads to a significant improvement in OS and an increase in the time to transition to castration resistance. The choice of therapy sequence in advanced PCa should be based, among other things, on the side-effect profiles of the substances and patient’s preferences. Within metastatic castration resistant prostate carcinoma (mCRPCa) setting, the therapy with abiraterone, enzalutamide, docetaxel, cabazitaxel and radium-223 is approved and indicated in Europe. Respectively, five substances are available, each of which has led to a significant increase in survival time in phase III studies. The optimal therapy sequence in the mCRPCa stage is still unclear. The current trend in personalised medicine in the next decade in therapy, regarding prostate carcinoma, are poly(ADP)-ribose polymerase (PARP) inhibitors, which are and will be available as an effective therapy option for patients with mutations in DNA repair genes. The most important question is when and how patients should be tested for mutations in DNA repair genes and to which line of therapy will PARP inhibitors belong.