Abstract
OBJECTIVE: Comparison of complications and oncology outcomes of immunotherapy alone and combination in metastatic castration-resistant prostate cancer (mCRPC). METHODS: As of March 2025, a systematic search on the application of immunotherapy alone with immunotherapy combined with other treatments (immunotherapy combined with radiotherapy/endocrine therapy, etc.) in the Embase, PubMed, and Web of Science databases for mCRPC. The complication and oncology outcome data from the study were collected for subsequent analysis. Stata17 software is used for data analysis. RESULTS: A total of nine studies were included. Compared with immunotherapy alone, immunotherapy combined with other treatments increased the overall survival of patients (effect = 0.67, 95% Cl [0.35, 0.98], P < 0.05) and median survival time (effect = 0.74, 95% Cl [0.45, 1.02], P < 0.05). The response rate of PSA50 in patients was increased (OR = 3.78, 95% Cl [1.12, 10.77], P < 0.05). There was no significant difference in the overall complication rates between the two. CONCLUSION: Preliminary findings so far show that immunotherapy in combination with other therapies improves overall survival, median survival time, and PSA50 response rate, with no significant difference in overall complication rate between the two groups. This conclusion is based on the pooled results of nine studies, which are small in number, and more multicenter, high-quality studies are needed to confirm this.