The efficacy of immune checkpoint inhibitors in metastatic castration-resistant prostate cancer: A meta-analysis and reconstructed individual patient data analysis

Some immune checkpoint inhibitors (ICI) has been used for men with specific metastatic castration-resistant prostate cancer (mCRPC). However, inconsistent results of ICI for unselected mCRPC population raise concerns. The primary outcomes were overall survival (OS) and radiographic progression-free survival (PFS), and the secondary outcomes included objective response rate (ORR). Individual patient data (IPD) were reconstructed from reported survival curve, and Kaplan–Meier method was used to evaluate the efficacy. Data of 1580 patients from 21 clinical trials were analyzed without biomarker-selected indications. The pooled 1-y and 2-y OS were 63% and 39%, while pooled 6-month and 12-month PFS were 41% and 17%. ICI plus other agent showed more OS and PFS benefits comparing with mono or dual ICI therapy (All P < .05). Combination therapy with ICI showed encouraging but preliminary signs in mCRPC. Future large trials focusing on combination regimens of ICI are needed. Registration: PROSPERO (CRD420251087847).