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

• Sebastiano Buti ^[1] ; Fausto Petrelli ^[2] ; Antonio Ghidini ^[3] ; Ivano Vavassori ^[4] ; Umberto Maestroni ^[5] ; Melissa Bersanelli ^[1]
  1. [1] Medical Oncology Unit, University Hospital of Parma, Parma, Italy
  2. [2] Medical Oncology Unit, Medical Sciences Department, ASST Bergamo Ovest, Piazzale Ospedale 1, 24047 Treviglio, BG, Italy
  3. [3] Oncology Unit, Casa di Cura Igea, Milan, Italy
  4. [4] Urology Unit, ASST Bergamo Ovest, Treviglio, BG, Italy
  5. [5] Urology Unit, University Hospital of Parma, Parma, Italy

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 22, Nº. 9, 2020, págs. 1657-1663
• Idioma: inglés
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• Resumen

  • Purpose Considering the recent publication of the results of several clinical trials for metastatic clear cell renal cell carci- noma (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.