Role of Lipids and Lipid Metabolism in Prostate Cancer Progression and the Tumor’s Immune Environment

SIMPLE SUMMARY: Cholesterol, lipids, and lipid metabolism are important in prostate cancer. Lipid metabolism interacts with androgens which are of clear importance in prostate cancer. Additionally, lipid metabolism is intimately involved in the interaction between immune and cancer cells. During cancer progression, there are changes in lipid metabolism in both prostate cancer cells and immune cells; furthermore, these cells can interact with each other. Lipids and cholesterol in the circulation also have a role and may prove to be a future target for diagnostic tools and surveillance in prostate cancer. ABSTRACT: Modulation of lipid metabolism during cancer development and progression is one of the hallmarks of cancer in solid tumors; its importance in prostate cancer (PCa) has been demonstrated in numerous studies. Lipid metabolism is known to interact with androgen receptor signaling, an established driver of PCa progression and castration resistance. Similarly, immune cell infiltration into prostate tissue has been linked with the development and progression of PCa as well as with disturbances in lipid metabolism. Immuno-oncological drugs inhibit immune checkpoints to activate immune cells’ abilities to recognize and destroy cancer cells. These drugs have proved to be successful in treating some solid tumors, but in PCa their efficacy has been poor, with only a small minority of patients demonstrating a treatment response. In this review, we first describe the importance of lipid metabolism in PCa. Second, we collate current information on how modulation of lipid metabolism of cancer cells and the surrounding immune cells may impact the tumor’s immune responses which, in part, may explain the unimpressive results of immune-oncological treatments in PCa.