Comparative efficacy and safety of immunotherapy in the first-line treatment of metastatic renal cell carcinoma: a systematic review and network meta-analysis.

Abstract

BACKGROUND:

With the advances in immune checkpoint inhibitor therapy, several novel treatment options for metastatic renal cell carcinoma (mRCC) patients have recently emerged. The present study explored the optimal first-line immunotherapy for mRCC through a Bayesian network meta-analysis of the latest research data.

METHODS:

PubMed, MEDLINE, EMBASE, American Society of Clinical Oncology (ASCO) meeting abstracts, and the Cochrane Library were searched up to July 2020 to identify any randomized controlled trials related to immunotherapy in the first-line treatment of mRCC. The primary outcome was progressionfree survival, and the secondary outcomes were overall survival and grade 3-4 adverse events.

RESULTS:

The network meta-analysis included 4,049 patients from 5 randomized controlled trials. Avelumab plus axitinib and pembrolizumab plus axitinib were the best treatment options in terms of progression-free survival. For overall survival, pembrolizumab plus axitinib had a 77.89% probability of being the preferred treatment. For adverse events, there was an 89.21% probability that pembrolizumab plus axitinib was the regimen with the worst side effects.

CONCLUSIONS:

Through a meta-analysis of the latest available first-line immunotherapy progression-free survival and overall survival data for mRCC, this study found that pembrolizumab plus axitinib might be the best immunotherapy option for first-line treatment. However, attention should be paid to the potential adverse events of this regimen.

• Authors: Zheran Liu, Ye Chen, Zhigong Wei, Yan He, Jingjing Wang, Xiaoli Mu, Ling He, Ruidan Li, Xiaolin Hu, Xingchen Peng
• Journal: Annals of palliative medicine (Ann Palliat Med) Vol. 10 Issue 3 Pg. 2805-2814 (Mar 2021) ISSN: 2224-5839 [Electronic] China
• PMID: 33615806 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Topics

• Bayes Theorem
• Carcinoma, Renal Cell (drug therapy)
• Humans
• Immunotherapy
• Kidney Neoplasms (drug therapy)
• Network Meta-Analysis