Assessing the clinical outcomes of immunotherapy and docetaxel combinations in metastatic castration-resistant prostate cancer: a meta-analysis

Abstract Background Despite breakthroughs in treatment, metastatic castration-resistant prostate cancer (mCRPC) continues to pose a substantial problem. This meta-analysis sought to assess the efficacy and safety of immunotherapy-chemotherapy combinations in mCRPC. Methods A thorough search of Clini...

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Main Authors: Azka Syed, Hasan Raza, Hameer Khan Khaskheli, Izza Rafique, Sameen Shahid, Nimra Shahzadi, Abdelrahman Sayed Al Komi, Abdullah A. Assiri, Muhammad Abbas Khokhar, Najeeb Ullah Khan
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14575-1
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author Azka Syed
Hasan Raza
Hameer Khan Khaskheli
Izza Rafique
Sameen Shahid
Nimra Shahzadi
Abdelrahman Sayed Al Komi
Abdullah A. Assiri
Muhammad Abbas Khokhar
Najeeb Ullah Khan
author_facet Azka Syed
Hasan Raza
Hameer Khan Khaskheli
Izza Rafique
Sameen Shahid
Nimra Shahzadi
Abdelrahman Sayed Al Komi
Abdullah A. Assiri
Muhammad Abbas Khokhar
Najeeb Ullah Khan
author_sort Azka Syed
collection DOAJ
description Abstract Background Despite breakthroughs in treatment, metastatic castration-resistant prostate cancer (mCRPC) continues to pose a substantial problem. This meta-analysis sought to assess the efficacy and safety of immunotherapy-chemotherapy combinations in mCRPC. Methods A thorough search of ClinicalTrials.gov, Embase, PubMed, SCOPUS, and Web of Science was performed to retrieve randomised controlled trials (RCTs) published between January 2000 and July 2024. The primary outcomes included overall survival (OS), progression-free survival (PFS), PSA response rate, time to PSA progression, and severe adverse events (SAEs). Data were aggregated using fixed-effect or random-effects models dependent on heterogeneity. Results Four RCTs involving 2,289 participants were included. The pooled results showed no statistically significant advantage of immunotherapy-chemotherapy combinations over placebo or docetaxel alone for OS (HR = 0.95; 95%CI: 0.79–1.14; P = 0.56), PFS (HR = 0.93; 95%CI: 0.80–1.07; P = 0.32), PSA response rate (RR = 0.99; 95%CI: 0.66–1.49; P = 0.96), time to PSA progression (HR = 1.01; 95%CI: 0.90–1.14; P = 0.85). The risk of SAEs was also not significantly different between the intervention and control groups (RR = 0.95; 95%CI: 0.71–1.29; P = 0.76). Conclusion Existing findings do not suggest a significant advantage of immunotherapy-chemotherapy combos over chemotherapy alone in mCRPC. However, the small number of trials and study heterogeneity call for caution in interpretation. Further high-quality RCTs are required to determine the role of these combinations in mCRPC treatment.
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spelling doaj-art-3cc2159c2d884587ad4e8d32e61d66592025-08-20T03:05:03ZengBMCBMC Cancer1471-24072025-07-0125111110.1186/s12885-025-14575-1Assessing the clinical outcomes of immunotherapy and docetaxel combinations in metastatic castration-resistant prostate cancer: a meta-analysisAzka Syed0Hasan Raza1Hameer Khan Khaskheli2Izza Rafique3Sameen Shahid4Nimra Shahzadi5Abdelrahman Sayed Al Komi6Abdullah A. Assiri7Muhammad Abbas Khokhar8Najeeb Ullah Khan9Department of Biosciences, Shaheed Zulfiqar Ali Bhutto Institute of Science and TechnologyInstitute of Molecular Biology and Biotechnology, Bahauddin Zakariya UniversityInstitute of Biotechnology and Genetic Engineering (IBGE) University of SindhDepartment of Biochemistry, University of AgricultureCentre for Applied Molecular Biology, University of the PunjabCenter for Excellence in Molecular Biology, University of the PunjabFaculty of Medicine, Al Azhar UniversityDepartment of Clinical Pharmacy, College of Pharmacy, King Khalid UniversityKing Edward Medical UniversityInstitute of Biotechnology and Genetic Engineering, The University of AgricultureAbstract Background Despite breakthroughs in treatment, metastatic castration-resistant prostate cancer (mCRPC) continues to pose a substantial problem. This meta-analysis sought to assess the efficacy and safety of immunotherapy-chemotherapy combinations in mCRPC. Methods A thorough search of ClinicalTrials.gov, Embase, PubMed, SCOPUS, and Web of Science was performed to retrieve randomised controlled trials (RCTs) published between January 2000 and July 2024. The primary outcomes included overall survival (OS), progression-free survival (PFS), PSA response rate, time to PSA progression, and severe adverse events (SAEs). Data were aggregated using fixed-effect or random-effects models dependent on heterogeneity. Results Four RCTs involving 2,289 participants were included. The pooled results showed no statistically significant advantage of immunotherapy-chemotherapy combinations over placebo or docetaxel alone for OS (HR = 0.95; 95%CI: 0.79–1.14; P = 0.56), PFS (HR = 0.93; 95%CI: 0.80–1.07; P = 0.32), PSA response rate (RR = 0.99; 95%CI: 0.66–1.49; P = 0.96), time to PSA progression (HR = 1.01; 95%CI: 0.90–1.14; P = 0.85). The risk of SAEs was also not significantly different between the intervention and control groups (RR = 0.95; 95%CI: 0.71–1.29; P = 0.76). Conclusion Existing findings do not suggest a significant advantage of immunotherapy-chemotherapy combos over chemotherapy alone in mCRPC. However, the small number of trials and study heterogeneity call for caution in interpretation. Further high-quality RCTs are required to determine the role of these combinations in mCRPC treatment.https://doi.org/10.1186/s12885-025-14575-1Metastatic castration-resistant prostatic cancerImmune checkpoint inhibitorsImmunotherapyDocetaxelMCRPC
spellingShingle Azka Syed
Hasan Raza
Hameer Khan Khaskheli
Izza Rafique
Sameen Shahid
Nimra Shahzadi
Abdelrahman Sayed Al Komi
Abdullah A. Assiri
Muhammad Abbas Khokhar
Najeeb Ullah Khan
Assessing the clinical outcomes of immunotherapy and docetaxel combinations in metastatic castration-resistant prostate cancer: a meta-analysis
BMC Cancer
Metastatic castration-resistant prostatic cancer
Immune checkpoint inhibitors
Immunotherapy
Docetaxel
MCRPC
title Assessing the clinical outcomes of immunotherapy and docetaxel combinations in metastatic castration-resistant prostate cancer: a meta-analysis
title_full Assessing the clinical outcomes of immunotherapy and docetaxel combinations in metastatic castration-resistant prostate cancer: a meta-analysis
title_fullStr Assessing the clinical outcomes of immunotherapy and docetaxel combinations in metastatic castration-resistant prostate cancer: a meta-analysis
title_full_unstemmed Assessing the clinical outcomes of immunotherapy and docetaxel combinations in metastatic castration-resistant prostate cancer: a meta-analysis
title_short Assessing the clinical outcomes of immunotherapy and docetaxel combinations in metastatic castration-resistant prostate cancer: a meta-analysis
title_sort assessing the clinical outcomes of immunotherapy and docetaxel combinations in metastatic castration resistant prostate cancer a meta analysis
topic Metastatic castration-resistant prostatic cancer
Immune checkpoint inhibitors
Immunotherapy
Docetaxel
MCRPC
url https://doi.org/10.1186/s12885-025-14575-1
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