Androgen deprivation therapy has been proved to be highly effective in the treatment, but it ends up to progress to metastatic castration resistant prostate cancer. Prostate specific membrane antigen-targeted therapy shows a promising treatment effect in metastatic castration resistant prostate cancer patients. But the resistance to radioligand therapy is unavoidable and the toxicity is challenging. Exploring the combination therapy of radioligand is imminent.

This meta-analysis was conducted following the PRISMA 2020 reporting guidelines by searching Medline, Embase and Cochrane. The studies in which radioligand was combined with other therapy were included in. The tumor response rate, overall survival and toxicity were extracted to estimate the efficacy and safety.

A total of eight studies and 669 patients were included. The pooled tumor response rate was 53.4%. As for survival analysis, the pooled overall survival was 15.5 months and the median PFS was 7.3 months. In toxicity analysis, the incidence of grade ≥ III adverse events were low. There was no statistically significant between monotherapy and combined therapy in toxicity.

In summary, our meta-analysis demonstrated that efficacy and safety of the combination therapy of radioligand in metastatic castration resistant prostate cancer patients.