New first-line immunotherapy-based combinations for metastatic renal cell carcinoma: A systematic review and network meta-analysis.

Bayes Theorem Carcinoma, Renal Cell / pathology Female Humans Immunologic Factors / therapeutic use Immunotherapy Kidney Neoplasms / pathology Male Network Meta-Analysis
First line Immunotherapy Network meta-analysis Renal carcinoma

Journal

Cancer treatment reviews
ISSN: 1532-1967
Titre abrégé: Cancer Treat Rev
Pays: Netherlands
ID NLM: 7502030

Informations de publication

Date de publication:
May 2022
Historique:
received: 23 11 2021
revised: 03 03 2022
accepted: 06 03 2022
pubmed: 22 3 2022
medline: 4 5 2022
entrez: 21 3 2022
Statut: ppublish

Résumé

Several first-line immune-checkpoints inhibitors (ICI) based combinations have been studied in metastatic renal cell carcinoma (mRCC) without any direct comparison between the regimens. The objective of this systematic review and network meta-analysis was to provide the most updated evidence about the preferred first line ICI-based regimen for mRCC. We searched various databases, including PubMed, Web of Science and Scopus and the major conference proceedings (ASCO, ESMO). Eligible studies were randomized trial, published before June 2021 that evaluated first-line, ICI-based combinations compared with the standard of care in mRCC. Screening was performed independently by two investigators. A Cochrane risk-of-bias tool was used to assess trial quality. Relative effects of competing treatments were assessed by Bayesian network meta-analysis. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was used. Outcomes included overall survival (OS), progression-free survival (PFS), overall response rate, complete response and adverse events. Six trials with 5478 patients comparing 7 treatments were identified. Network meta-analysis showed that lenvatinib plus pembrolizumab had the highest probability to be the best treatment in terms of OS (surface under the cumulative ranking (SUCRA) 80.7%) and PFS (SUCRA 99.6%), while in sarcomatoid patients, nivolumab plus cabozantinib had the highest rank in terms of survival outcomes (SUCRA 85.8% and SUCRA 77.3%, respectively). Although we established a ranking among new first-line mRCC treatment combinations, the absence of direct comparisons between the multiple treatment options represents a major hurdle in establishing optimal therapeutic sequences. Our results could represent a starting point for head-to-head trials between the most promising combinations.

Identifiants

DOI: 10.1016/j.ctrv.2022.102377 PMID: 35313232
pubmed: 35313232
pii: S0305-7372(22)00041-X
doi: 10.1016/j.ctrv.2022.102377
pii:
doi:

Substances chimiques

Immunologic Factors 0

Types de publication

Journal Article Meta-Analysis Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

102377

Informations de copyright

Copyright © 2022. Published by Elsevier Ltd.

Auteurs

Pasquale Lombardi (P)

Phase 1 Unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.

Marco Filetti (M)

Phase 1 Unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.

Rosa Falcone (R)

Phase 1 Unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.

Rossella Di Bidino (R)

Department of Health Technology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Italy.

Roberto Iacovelli (R)

Comprehensive Cancer Center, UOC Medical Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy.

Chiara Ciccarese (C)

Comprehensive Cancer Center, UOC Medical Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy.

Emilio Bria (E)

Comprehensive Cancer Center, UOC Medical Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Section of Medical Oncology, Department of Translational Medicine and Surgery, Università Cattolica Del Sacro Cuore, Rome, Italy.

Giampaolo Tortora (G)

Comprehensive Cancer Center, UOC Medical Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Section of Medical Oncology, Department of Translational Medicine and Surgery, Università Cattolica Del Sacro Cuore, Rome, Italy.

Giovanni Scambia (G)

Scientific Directorate, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.

Gennaro Daniele (G)

Phase 1 Unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy; Scientific Directorate, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy. Electronic address: gennaro.daniele@policlinicogemelli.it.

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Classifications MeSH

questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Théorème de Bayes › New first-line immunotherapy-based...
questionsmedicales.fr › Maladies urogénitales › Maladies urologiques › Tumeurs urologiques › Tumeurs du rein › Néphrocarcinome › New first-line immunotherapy-based...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › New first-line immunotherapy-based...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Effets physiologiques des médicaments › Facteurs immunologiques › New first-line immunotherapy-based...
questionsmedicales.fr › Thérapeutique › Biothérapie › Immunothérapie › New first-line immunotherapy-based...
questionsmedicales.fr › Maladies urogénitales › Maladies urologiques › Tumeurs urologiques › Tumeurs du rein › New first-line immunotherapy-based...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Méthodologie en recherche épidémiologique › Méta-analyse comme sujet › Méta-analyse en réseau › New first-line immunotherapy-based...