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Immunotherapy-based combinations versus standard first-line treatment for metastatic clear cell renal cell carcinoma: a systematic review and meta-analysis

A Correspondence to this article was published on 20 April 2020

Abstract

Purpose

Considering the recent publication of the results of several clinical trials for metastatic clear cell renal cell carcinoma (mRCC), we performed a systematic review and meta-analysis of randomized studies comparing standard first-line VEGFR-targeted therapy to immune checkpoint inhibitors-based combinations for mRCC patients.

Methods

3960 patients from 5 randomized clinical trials where available for evaluation.

Result

In the all-comers population, immunotherapy-based combinations were able to decrease the risk of death over the standard of care by 26% (HR 0.74; 95% CI 0.60–0.92; p = 0.006), to decrease the risk of progression by 21% (HR 0.79; 95% CI 0.72–0.86; p < 0.00001), and to increase the relative risk of response by 40% (HR 1.40; 95% CI 1.11–1.77; p = 0.006). For poor/intermediate-risk patients, the risk of death is decreased by 41% and the risk of progression by 27%.

Conclusions

The benefit of immunotherapy-based combinations in mRCC patients is independent from the IMDC risk group, but it is stronger for poor/intermediate-risk patients.

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Correspondence to Fausto Petrelli.

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Conflict of interest

Dr. Bersanelli received research funding by Roche, Pfizer, Seqirus, AstraZeneca, Bristol-Myers Squibb, Novartis, and Sanofi; she also received honoraria for advisory role and as speaker at scientific events by Bristol-Myers Squibb, Novartis, and Pfizer. Dr. Buti received honoraria for advisory role and as speaker at scientific events by Bristol-Myers Squibb, Novartis, IPSEN, and AstraZeneca. All other authors have no conflict of interest to declare.

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Buti, S., Petrelli, F., Ghidini, A. et al. Immunotherapy-based combinations versus standard first-line treatment for metastatic clear cell renal cell carcinoma: a systematic review and meta-analysis. Clin Transl Oncol 22, 1657–1663 (2020). https://doi.org/10.1007/s12094-020-02292-z

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Keywords

  • Renal cell carcinoma
  • Immune checkpoint inhibitors
  • First-line treatment
  • Tyrosine kinase inhibitors
  • Sunitinib
  • Anti-PD-1
  • Anti-PD-L1
  • Meta-analysis